title: Proximal humeral fractures with a severe varus deformity treated by fixation with a locking plate.
abstract: We treated 47 patients with a mean age of 57 years (22 to 88) who had a proximal humeral fracture in which there was a severe varus deformity, using a standard operative protocol of anatomical reduction, fixation with a locking plate and supplementation by structural allografts in unstable fractures. The functional and radiological outcomes were reviewed. At two years after operation the median Constant score was 86 points and the median Disabilities of the Arm, Shoulder and Hand score 17 points. Seven of the patients underwent further surgery, two for failure of fixation, three for dysfunction of the rotator cuff, and two for shoulder stiffness. The two cases of failure of fixation were attributable to violation of the operative protocol. In the 46 patients who retained their humeral head, all the fractures healed within the first year, with no sign of collapse or narrowing of the joint space. Longer follow-up will be required to confirm whether these initially satisfactory results are maintained.
authors.affiliation: Edinburgh Shoulder Clinic, Royal Infirmary of Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK. c.mike.robinson@ed.ac.uk
authors.forename: C M
authors.initials: CM
authors.lastname: Robinson
authors.forename: J R
authors.initials: JR
authors.lastname: Wylie
authors.forename: A G
authors.initials: AG
authors.lastname: Ray
authors.forename: N J
authors.initials: NJ
authors.lastname: Dempster
authors.forename: B
authors.initials: B
authors.lastname: Olabi
authors.forename: K T M
authors.initials: KT
authors.lastname: Seah
authors.forename: M A
authors.initials: MA
authors.lastname: Akhtar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult