[Surgical treatment of proximal humeral fractures. Is the T-plate still adequate osteosynthesis procedure?].
No general agreement exists on the operative therapy of displaced proximal humeral fractures. The purpose of this study is to evaluate different internal fixation techniques (plate fixation, figure-of-eight tension wiring, lagscrew) and to verify if the plate fixation is still an adequate therapy in the treatment of displaced proximal humeral fractures. A follow-up investigation was conducted in 51 patients after an average of 4.2 years. A T-plate fixation was performed in 62.7%, a minimal invasive technique in 21.6% and a shoulder prosthesis in 15.7% of these patients. At follow-up 60.7% of the patients with a 3- or 4-part fracture had good or excellent results in the Constant score (59% T-plate, 66% minimal invasive). Humeral head necrosis was seen in 15.9% of the patients with a T-plate fixation and in 9.1% of the patients with minimal invasive techniques. Based on our results and the reviewed literature we can confirm advantages of the minimal invasive techniques in the treatment of 4-part fractures. However, good results can be obtained with T-plate fixation in 2- or 3-part fractures especially in younger patients.
Bäthis
H
H
Abteilung für Unfallchirurgie, II. Chirurgischer Lehrstuhl, Universität zu Köln. Holger.Baethis@uni-koeln.de
Tingart
M
M
Bouillon
B
B
Tiling
T
T
D000367:Age Factors; D001860:Bone Plates; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome