title: Fixation of fractures of the proximal humerus with the PlantTan Humerus Fixator Plate: early experience with a new implant.
abstract: The majority of fractures of the proximal humerus can be managed nonoperatively. However, displaced fractures generally require operative repair, and in the young patient with good bone quality, the results are usually satisfactory. In contrast, the osteoporosis found in the elderly patient makes internal fixation problematic and frequently contributes to failure of fixation and poor results. We report our early experience with a new plate that locks two humeral head cancellous screws to the plate. In 3 of 7 patients, all under 65 years of age, the results were good. However, in the remaining 4 patients, all over the age of 75 years, there was a 100% failure rate, with screw penetration of the head in 3 patients and secondary displacement of the fracture at 7 days postoperatively in another. We conclude that this implant is unsatisfactory for patients with osteopenic bone in the humeral head.
authors.affiliation: Orthopaedic Service, University Hospital of Geneva, Switzerland.
authors.forename: Christophe
authors.initials: C
authors.lastname: Sadowski
authors.forename: Nicolas
authors.initials: N
authors.lastname: Riand
authors.forename: Richard
authors.initials: R
authors.lastname: Stern
authors.forename: Pierre
authors.initials: P
authors.lastname: Hoffmeyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*