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[Complication analysis of proximal humeral fractures treated with locking plate]
Zhong-guo Fu1, Lei Deng, Lu Bai
1Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China.
Objective:
To analyze complications of surgically treated proximal humeral fractures with locking plate.
Methods:
Eighty three (30 males and 53 females) coherent unstable proximal humeral fractures were treated with locking plate from January 2007 to January 2010 with a mean follow-up lasting 23.5 months ( 10-51 months ). Their mean age was 66.4 years (33-89 years). The patients were evaluated with outpatient physical examination, X-ray film, visual analogue scale (VAS), and Constant-Murley scores. Complications and functional outcome of the involved shoulders were recorded and estimated. Complications were diagnosed in 15 cases, varus malunion in 6, humeral head necrosis in 3, delayed union in 1, screw cut-out in 3, and subacromio-impingement in 3.Four cases were combined with two or more complications.
Result:
Four-part fractures had higher complication risks in implant related complications (P=0.009)and none implant related complications (P=0.003).Age and comobities had little influence on complication occurrence.
Conclusion:
Although locking plate provides optimal clinical results in proximal humeral fracture management, its complications should be highly considered. Preoperative evaluation, implant option, accurate reconstructions and rehabilitations are key points to restore the shoulder function.
