Plate fixation of proximal humeral fractures

We performed open reduction and internal fixation with a T-buttress plate in 32 fractures of the proximal humerus with severe displacement and/or fracture dislocation. In 27 cases acceptable reduction was achieved. In four cases infection developed, and the implant was removed in five cases because of impingement of the plate under the acromion and in two cases because of loosening. There was no nonunion, but four humeral head necroses. At the re examination of 20 patients after 2-7 years, nine were excellent or satisfactory and eleven unsatisfactory or poor. We conclude that the buttress plate offers satisfactory reduction and good stability at a high risk for complications. The indications for this method should be carefully considered, notably in the elderly, and the operation should only be performed by experienced orthopedic surgeons.