Abstract
Background: Displaced proximal humeral fractures (PHF) remain a challenge to the orthopedic surgeon. Conservative treatment yield poor results in the majority of these fractures. Surgical treatment, although preferable, lacks the proper exposure and fixation technique.
The locking compression plate (LCP), which is inserted in a minimal invasive technique, utilizing an anterolateral approach to the proximal humerus, allows adequate reduction and fixation, while minimizing the risk for complications derived from extensive exposure and poor fixation.
Methods: All patients admitted to our department with a complicated PHF between Jan 2004 and May 2005 were included. After obtaining informed consent, open reduction and internal fixation was performed through an anterolateral minimal invasive approach. After exposure and reduction with or without acromioplasty and rotator cuff repair, the fracture was fixated with a LCP 3.5mm. Patients were encouraged to perform pendular movements on the first post-operative day.
The patients were followed closely beginning 2 weeks post-operatively and afterwards on a bi-monthly basis. Immediate complications, radiographic and functional outcome were noted.
Results: 22 patients have been treated according to the treatment protocol during the study period. Minimal follow up of three months is available. A single complication was noted (deep wound infection which necessitated hardware removal). No nerve injury or hardware failures were noted.
Functional outcome was good, patients regained 120°±25 of flexion, 112°±27 of abduction and 17°±8 of external rotation.
Conclusions: The anterolateral approach to the shoulder and fixation with a LCP plate is a safe technique in our hospital. Rigid stabilization allows for early shoulder activation which results in a good range of motion and functional outcome on short-term follow up. Further study and long-term follow up are needed to validate this technique in treating complex proximal humerus fractures.
The abstracts were prepared by Orah Naor, IOA Co-ordinator and Secretary. Correspondence should be addressed to Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
