New approach to angular stable plate fixation of multifragmentary, displaced proximal humeral fractures in the elderly
Abstract
The frequency of proximal humeral fractures shows an increasing tendency, especially in the elderly, who are often affected by osteoporosis. Conservative treatment is efficient in simple cases without displacement, while the treatment of multifragmentary and displaced fractures poses a challenge. Angular stable plate fixation is the preferred method for osteosynthesis, however, complications are frequent. We perform valgising angular stable plate fixation at our institute routinely since 2019 to treat osteoporotic multifragmentary proximal humeral fractures. In our present study, we retrospectively evaluated the short-term clinical and radiological outcomes of 37 patients over 70 years old (31 women and 6 men, age: 78,4±6,4). Follow-up time was 14,5±5,3 months and 10 patients showed favorable, 6 satisfactory and 3 poor functional outcomes. Constant-Murley Score was 81,8±11,0. Functional outcomes were unrelated to age, type of fracture, BMI and known primary diseases. The cumulative complication rate was 10,8% and revision rate was 5,4%. We experienced excellent functional outcomes with a low complication rate following valgising angular stable plate fixation for proximal humeral fractures due to the optimal head and plate position. The method is especially effective for displaced, multifragmentary fractures with weakened bone structure.
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