title: Proximal humeral fractures in geriatric patients. Is the angle-stable plate osteosynthesis really a breakthrough?
abstract: This is a retrospective study of the results of angle-stable plating of displaced 3- or 4- part fractures of the proximal humerus in 92 geriatric patients treated between 2/2000 and 2/2004. At final follow-up patients were clinically evaluated using the Constant-Murley score and were examined radiologically. The mean non-age-related Constant-Murley score was 69.8 points. A clear correlation was found between the final score and the quality of reposition of the tuberosities and/or plate position. Accurate reduction and plate positioning led to a significantly better functional result. For 28 patients (30.4%), sinkage of the humeral head into the shaft occurred despite angle-stable anchoring. The currently celebrated angle-stabilising plates did not lead to a significant improvement in functional outcome, compared with other established osteosynthesis procedures.
authors.affiliation: Department of Surgery, BG-Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. thomasmfrangen@web.de
authors.forename: Thomas Manfred
authors.initials: TM
authors.lastname: Frangen
authors.forename: Ernst Josef
authors.initials: EJ
authors.lastname: Müller
authors.forename: Marcel
authors.initials: M
authors.lastname: Dudda
authors.forename: Stephan
authors.initials: S
authors.lastname: Arens
authors.forename: Gert
authors.initials: G
authors.lastname: Muhr
authors.forename: Thomas
authors.initials: T
authors.lastname: Kälicke
mesh_terms: D001860:Bone Plates; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D006811:Humerus; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015599:Trauma Severity Indices