title: Second generation locked plating of proximal humerus fractures--a prospective multicentre observational study.
abstract: Surgical treatment of most displaced proximal humerus fractures is challenging due to osteoporosis. Locking plates are intended to provide superior mechanical stability. In a prospective multicentre study 131 patients were treated with second generation locked plating (NCB-PH, Zimmer, Inc.). The open procedure (n = 78) was performed using a deltopectoral approach; the minimally invasive technique (n = 53) involved percutaneous reduction and an anterolateral deltoid split approach. Clinical and radiological follow-up was obtained. Improvement in function (ROM) was statistically significant. Fracture type (AO) had the most significant impact on the incidence of complications. The most frequent complications detected were intra-articular screw perforation (15%) and secondary displacement (8%). Complication rate and functional outcome of the NCB-PH are comparable to reports in the literature. Not all problems are likely to be solved by this new generation of implants, i.e. secondary dislocation still occurred in 8% of our patients.
authors.affiliation: Department of Orthopaedic Trauma, University of Ulm, Ulm, Germany. goetz.roederer@uniklinik-ulm.de
authors.forename: Götz
authors.initials: G
authors.lastname: Röderer
authors.forename: Johannes
authors.initials: J
authors.lastname: Erhardt
authors.forename: Markus
authors.initials: M
authors.lastname: Kuster
authors.forename: Paul
authors.initials: P
authors.lastname: Vegt
authors.forename: Christian
authors.initials: C
authors.lastname: Bahrs
authors.forename: Lothar
authors.initials: L
authors.lastname: Kinzl
authors.forename: Florian
authors.initials: F
authors.lastname: Gebhard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017760:Bone Malalignment / Q000601:surgery; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D025981:Hip Injuries / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012784:Shoulder Fractures / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult