Abstract
Fractures of the proximal humerus account for 4 to 5% of all fractures. Most occur in elderly individuals caused in part by osteoporosis.
Conservative treatment frequently led to poor clinical results because of the inability to gain and maintain satisfactory reduction.
The preferred method for these fractures was open reduction and internal fixation especially in those fractures with displacement and in young patients.
In 18 patients the fracture was operatively reduced and was secured with a plate and screws.
Methods of plating: T plate, clover leaf plate or blade plate modified. Delayed union and non-union of humeral head fracture is also an indication for open reduction and internal fixation by plate and screws.
A consecutive series of 18 patients with displaced fracture and fracture dislocation, followed for a minimum period of one year were analyzed.
The age of the patient range from 16 to 62 years.
The fractures were classified according to Neer 91970).
The aim of treatment was accurate reduction and stable fixation of the fracture with plate and screw.
The most common technical error was a too high positioning of the plate caused implant impinged under the acromion during abduction. No aseptic necrosis of the humeral head was observed. There was no deep infection.
11 patients had an excellent or good result, 7 had a fair result, and 1 had a poor result.
Koval in a biomechanical cadaver study was to compare the mechanical stability of ten different fixation, techniques used of stabilize surgical neck fractures of the proximal humerus in both osteopenic and non osteopenic bone.
The AO five holes T plate provided significantly greater resistance to displacement than all other methods tested the fresh-frozen specimens. Their effectiveness diminished in the presence of osteopenia.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
