Humeral blade plate fixation of intercalary allografts and segmentally comminuted proximal humeral fractures: a preliminary report

The AO 90 degrees humeral blade plate is a relatively new device, whose pri mary indication and previously described use is for proximal humeral fractu re non-union. This study describes the use of the humeral blade plate for e xtended indications-fixation of segmentally comminuted proximal humeral fra ctures in two patients and fixation of humeral intercalary allografts after primary humeral neoplasm resection in three patients. A mean follow-up of 20 months revealed union in both fractures and five of the six allograft-ho st junctions. One patient required subsequent bone grafting for non-union a t a proximal allograft-host junction. Functional results were excellent in three patients, good in one, and fair in one. Problems encountered intraope ratively were directly related to the limited array of implants. The long p lates which were needed had blades which were too long and required intra-o perative trimming in three cases. In four cases, additional plates were use d to supplement the blade plate for distal fixation. In conclusion, the hum eral blade plate is a useful device for fixation in these extended indicati ons, but longer plates with 30.0 and 40.0-mm blade lengths should be made a vailable. (C) 2000 Elsevier Science Ltd. All rights reserved.