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Online ISSN 1827-1707
Aprato A., Ferro L., Maderni A., Sisto R., Massè A.
Prima Clinica Ortopedica e Traumatologica Ospedale CTO Università degli Studi di Torino, Torino
Aim. Controversy persists concerning the preferred treatment of displaced fractures of the proximal part of the humerus. The present study was undertaken to evaluate the results of open reduction and internal fixation of three- and four-part fractures of the proximal part of the humerus and the functional limitations of patients.
Methods. We assessed the intermediate and longterm results for 17 patients with a three- or four-part fracture of the proximal part of the humerus who underwent open reduction and internal fixation with screws and Locking Compression Plate (LCP) by Synthes-Mathys. The Constant-Murley score and UCLA shoulder rating were used as evaluation tests.
Results. After an average of 8.3 month of follow-up, 36% of patients had an excellent result on the basis of the UCLA score, no patient had a good score, another 36% of patients had a sufficient result, whereas the rest 28% of patients had poor results. The mean score at Constant test was 70 points (range from 28 to 100).
Conclusion. Open reduction and internal fixation with screws and plate LCP yields good functional results in most patients. This option should be considered even for patients with complex fracture that are associated with a high risk for avascular necrosis of the humeral head.