Dual Locking Plate Osteosynthesis for 3- or 4-Part Proximal Humeral Fractures Combined with Multiple Fractures of the Gr
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ORIGINAL ARTICLE
Dual Locking Plate Osteosynthesis for 3‑ or 4‑Part Proximal Humeral Fractures Combined with Multiple Fractures of the Greater Tuberosity Yongchuan Li1 · Nan Lu1 · Fan Zhang1 · Zhibin Zhou1 · Liangyu Zhao1 · Aimin Chen1 Received: 7 May 2020 / Accepted: 3 October 2020 © Indian Orthopaedics Association 2020
Abstract Background This retrospective study was conducted to evaluate the efficacy of dual locking plate osteosynthesis for treating 3- or 4-part proximal humeral fractures combined with multiple fractures of the greater tuberosity. Methods From January 2012 to December 2018, 19 skeletally mature patients, who suffered 3- or 4-part proximal humeral fractures combined with multiple fractures of the greater tuberosity, were treated with open reduction and internal fixation using a dual locking plate technique through a delto-pectoral approach. Indexes for evaluation included fracture healing, quality of reduction, and incidence of complications (infections, screw perforation into the glenohumeral joint, subacromial impingement, hardware failure, avascular necrosis, and loss of reduction). Shoulder function was evaluated using Constant– Murley scoring. Results The patients were assessed at a mean time of 25.3 months after surgery. Union of fractures was radiographically confirmed for all 19 patients. The mean Constant–Murley patient score was 85.2 points, and complications were identified in two patients during follow-up evaluations. Conclusions The method of using dual locking plate osteosynthesis through a delto-pectoral approach resulted in a satisfactory union rate, excellent fracture reduction, low complication rate and good shoulder function for patients with complex proximal humeral fractures. The method is effective for treating 3- or 4-part proximal humeral fractures combined with multiple fractures of the greater tuberosity. Keywords Proximal humeral fracture · Internal fixation · Plating · Greater tuberosity Abbreviations S3 Spatial Subchondral Support PHILOS Proximal humerus-locking compression plate VA-LCP Variable Angle LCP
Yongchuan Li, Nan Lu and Fan Zhang contributed equally to this work. * Liangyu Zhao [email protected] * Aimin Chen [email protected] 1
Department of Orthopaedic Trauma Surgery, Orthopaedic Institute of PLA, Shanghai Changzheng Hospital Affiliated to Navy Military Medical University, 415 Fengyang Road, Shanghai 200003, China
Background Proximal humeral fracture is one of the most common types of fracture, especially in elderly people with osteoporosis. They account for approximately 6% of all fractures seen in accident and emergency departments [1–3]. It is the third most common fracture overall following hip and distal radial fracture [4–6]. Most proximal humeral fractures are undisplaced or minimally displaced [7], and can be successfully treated using conservative methods [8]. However, displaced fractures require surgical treatment. The most frequently used classification for proximal humeral fractures is Neer classification [9–11]. Neer
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