title: Treatment of three- and four-part fractures of the proximal humerus with a modified cloverleaf plate.
abstract: Twenty-six patients, ranging in age from 19 to 62 years (average 55), were evaluated an average of 6 years and 2 months (range 1-12 years) after open reduction and internal fixation of a three- or four-part fracture of the proximal humerus using a modified cloverleaf plate. Six patients had an associated dislocation of the humeral head. All fractures healed. No avascular necrosis of the humeral head was observed at follow-up. Twenty-two patients had an excellent result, two a good result, and two a fair result. The modified cloverleaf plate proved to be an excellent method for the treatment of proximal humerus fractures. Open reduction and internal fixation of three- and four-part fractures of the proximal humerus should be considered as initial treatment by an experienced surgeon, oven before use of a prosthetic replacement, which is recommended only for elderly patients with osteopenia.
authors.affiliation: Department of Functional Restoration, Stanford University Medical Center, California 94305.
authors.forename: R D
authors.initials: RD
authors.lastname: Esser
mesh_terms: D000328:Adult; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011184:Postoperative Period; D011859:Radiography; D012784:Shoulder Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012785:Shoulder Joint; D016896:Treatment Outcome