Dual plate for comminuted proximal humerus fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Severe metaphyseal comminuted fractures of the proximal humerus present complex treatment challenges.
• Maintaining posteromedial buttress integrity is crucial for successful proximal humerus fracture fixation.

Purpose of the Study:

• To evaluate the radiological, clinical outcomes, and complication rates of dual plate fixation for severe metaphyseal comminuted proximal humerus fractures.
• Assess the efficacy of dual plating in achieving anatomical reduction and bone union.

Main Methods:

• A cohort of 21 patients with proximal humerus fractures and impaired posteromedial buttress were treated with dual plate fixation.
• Utilized a Proximal Humeral Locking plate and a Variable Angle Plate.
• Radiographic analysis included neck shaft angle (Paavolainen method) and anterior-posterior angulation; union duration was assessed.

Main Results:

• Good anatomical reduction was achieved in 80.95% of patients, with fair results in 14.28% and poor in 4.77%.
• The study noted one case of impingement and one case of avascular necrosis.
• The dual plate technique demonstrated stable fixation and satisfactory union.

Conclusions:

• Dual plate fixation is a reliable technique for managing severe metaphyseal comminuted proximal humerus fractures.
• This method yields satisfactory clinical and radiological results, ensuring stable fixation.