Affiliation
Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Dublin, Ireland. neilburke@yahoo.co.ukIssue Date
2012-02Keywords
FRACTURESURGERY
Local subject classification
SURGERY, ORTHOPAEDICMeSH
Bone PlatesEvidence-Based Medicine
Fracture Fixation, Internal
Humans
Prevalence
Shoulder Fractures
Treatment Outcome
Metadata
Show full item recordCitation
Burke NG et al. Locking plate fixation for proximal humerus fractures. Orthopedics. 2012, 35 (2):e250-4Publisher
OrthopedicsJournal
OrthopedicsDOI
10.3928/01477447-20120123-41PubMed ID
22310414Abstract
Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.Item Type
ArticleLanguage
enISSN
1938-2367ae974a485f413a2113503eed53cd6c53
10.3928/01477447-20120123-41
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