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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
OSTEOSYNTESIS OF PROXIMAL FRACTURES GLENOHUMERAL FRACTURES.SYNTHESIS, PROSTHESIS,ARTHROSCOPY: A COMPARISON OF DIFFERENT TECHNIQUES
Minerva Ortopedica e Traumatologica 2006 August;57(4):305-12
language: English, Italian
Fixation of displaced proximal humeral fractures with Locking Compression Plate
Biasibetti A. 1, Maderni A. 1, Aprato A. 2, Sisto R. 1, Massè A. 3
1 Department of Traumatology Orthopaedic and Traumatological Hospital of Turin, Italy
2 Faculty of Medicine and Surgery University of Turin, Italy
3 I Clinic of Orthopaedic and Traumatology University of Turin, Italy
Aim. Controversy persists as to the treatment of the displaced fractures of the proximal humerus, since, after initial enthusiasm, the prosthetic treatment of this pathology seemed to give poorly reproducible results. A prospective study was therefore performed to evaluate the mid -term clinical and radiographical outcome of open reduction and internal fixation of displaced fractures of the proximal humerus.
Methods. A total of 33 patients, with displaced fracture of the proximal part of the humerus, underwent open reduction and internal fixation with LCP plate (SYNTHES-Mathys), as from January 2003. The Constant-Murley score and modified Constant-Murley’s score were recorded at 6 and 12 months and at the last follow-up.
Results. At a 6 month follow-up, the average score at Constant-Murley’s score was 75.65 points (range from 28 to 100) while at 12 months it was 75.65 (range from 34 to 100) with a statisticaly significant difference (P<0.01). Average Modified Constant score was 83.07 at 6 months and 90.58 at 12 months. Results showed a negative correlation between the patient’s age and Constant score at 12 months. No patient underwent a secondary arthroplasty with only one patient having radiographical evidence of partial necrosis of the humeral neck, without clinical symptoms.
Conclusions. Open reduction and internal fixation with screws and LCP plate, yields good functional results in most patients. This option could then be considered even for patients with complex fractures and the association of a high risk of avascular necrosis of the humeral head.