Proximal humeral fractures in geriatric patients. Is the angle-stable plate osteosynthesis really a breakthrough?

This is a retrospective study of the results of angle-stable plating of displaced 3- or 4- part fractures of the proximal humerus in 92 geriatric patients treated between 2/2000 and 2/2004. At final follow-up patients were clinically evaluated using the Constant-Murley score and were examined radiologically. The mean non-age-related Constant-Murley score was 69.8 points. A clear correlation was found between the final score and the quality of reposition of the tuberosities and/or plate position. Accurate reduction and plate positioning led to a significantly better functional result. For 28 patients (30.4%), sinkage of the humeral head into the shaft occurred despite angle-stable anchoring. The currently celebrated angle-stabilising plates did not lead to a significant improvement in functional outcome, compared with other established osteosynthesis procedures.