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http://dx.doi.org/10.5397/CiSE.2012.15.1.25

Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years  

Lee, Ki-Won (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Choi, Young-Joon (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Ahn, Hyung-Sun (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Kim, Chung-Hwan (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Hwang, Jae-Kwang (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Kang, Jeong-Ho (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Choo, Han-Ho (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Park, Jun-Seok (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Kim, Tae-Kyung (Department of Orthopedic Surgery, Gangneung Asan hospital, University of Ulsan College of Medicine)
Publication Information
Clinics in Shoulder and Elbow / v.15, no.1, 2012 , pp. 25-31 More about this Journal
Abstract
Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.
Keywords
Proximal humerus fracture; Polyaxial angular stable locking compression plate;
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Times Cited By KSCI : 2  (Citation Analysis)
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1 Bjorrkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand. 2004;75:741-5   DOI   ScienceOn
2 Krappinger D, Bizzoto N, Riedmann S, Kammerlander C, Hengg C, Kralinger FS. Predicting failure after surgical fixation of proximal humerus fractures. Injury. 2011;1:17-22.
3 Lee CW, Shin SJ. Prognostic factors for unstable proximal humerus fractures treated with locking plate fixation. J Shoulder Elbow Surg. 2009;18:83-8.   DOI   ScienceOn
4 Micic ID, Kim KC, Shin DJ, et al. Analysis of early failure of the locking compression plate in osteoporotic proximal humerus fractures. J Orthop Sci. 2009;14: 596-601.   DOI   ScienceOn
5 Zettl R, Müller T, Topp T, et al. Monoaxial versus polyaxial locking systems: a biomechanical analysis of different locking systems for the fixation of proximal humeral fractures. Int Orthop. 2011;35:1245-50.   DOI
6 Chudik SC, Weinhold P, Dahners LE. Fixed angle plate fixation in simulated fractures of the proximal humerus: a biomechanical study of a new device. J Shoulder Elbow Surg. 2003;12:578-88.   DOI   ScienceOn
7 Neer CS II. Displaced proximal humeral fractures: classification and evaluation. J Bone Joint Surg Am. 1970;52:1077-89.   DOI
8 Costant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-4.
9 Paavolainen P, Björkenheim JM, Slätis P, Paukku P. Operative treatment of severe proximal humerus fractures. Acta Orthop Scand. 1983;54:374-9.   DOI
10 Gardner MJ, Weil Y, Baker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21:185-91.   DOI   ScienceOn
11 Lill H, Hepp P, Korner J, et al. Proximal humeral fractures. how stiff should an implant be? A comparative mechanical study with new implants in human specimens. Arch Orthop Trauma Surg. 2003;123:74-81.   DOI
12 Agudelo J, Schürmann M, Stahel P, et al. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Ortho Trauma. 2007;21: 753-68.
13 Sommer C, Babst R, Muller M, Hanson B. Locking compression plate loosening and plate breakage: a report of four cases. J Orthop Trauma. 2004;18:571-7.   DOI   ScienceOn
14 Plecko M, Kraus A. Internal fixation of proximal humerus fractures using the locking proximal humerus plate. Opera Orthop Traumatol. 2005;17:25-50.   DOI
15 Kim DW, Kim CK, Jung SW, Kim HS. Operative treatment of displaced proximal humerus fractures with the angular stable Locking Compression Plate. J Korean Shoulder Elbow Soc. 2011;14:27-34.   DOI
16 Roderer G, Erhardt J, Kuster M, Vegt P, et al. Second generation locked plating of proximal humerus fractures--a prospective multicentre observational study. Int Orthop. 2011;35:425-32.   DOI
17 Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop. 2005;430:176-81.
18 Helmy N, Hintermann B. New trends in the treatment of proximal humerus fractures. Clin Orthop Relat Res. 2006;422:100-8.
19 Min WK, Sin SJ, Jeon IH, et al. Fixation failure of LCP during the treatment of proximal humerus fracture. J Korean Fracture Soc. 2006;19:188-92.   DOI
20 Shin SJ, Do NH, Song MH, Sohn HS. Minimal invasive plate osteosynthesis in proximal humerus fracture. J Korean Shoulder Elbow Soc. 2010;13:202-8.   DOI