Analysis of failure with the use of locked plates for stabilization of proximal humerus fractures
From: Bulletin of the NYU Hospital for Joint Diseases(Vol. 73, Issue 3.)
Publisher: J. Michael Ryan Publishing Co.
Document Type: Report
Length: 3,254 words
Objective: To evaluate factors associated with complications in a series of patients with proximal humerus fractures treated with locked plating. Design: Retrospective chart review. Setting: Level 1 Trauma Center. Patients and Methods: A retrospective review was performed on patients older than 18 years of age treated with a locked plate for a proximal humerus fracture between June 2007 and December 2011 in order to identify any factors associated with failure. Patients had a minimum of 6 months of clinical follow-up. Results: 78 proximal humerus fractures in 78 patients were stabilized using a locked plate. Twenty-four patients were lost to follow-up, while 54 patients were available for 6-month minimum follow-up and comprised the study group. A healing complication occurred in 20patients (37%) and consisted of loss of reduction (16), varus malunion (16), avascular necrosis (6) or implant penetration (1). Eleven of 54 patients (20%) required secondary surgery. Factors associated with a healing complication were number of fracture parts (p Conclusion: An overall complication rate of 37% was found in patients stabilized using a locked plate after sustaining a proximal humerus fracture. Factors associated with healing complications included increased number of fracture parts, increasing number of comorbidities, and initial varus malreduction. Patient selection for locked plating after proximal humerus fracture should incorporate many factors with meticulous attention to surgical technique.