Outcomes After Fixation of Proximal Humerus (OTA Type 11) Fractures in the Elderly Patients Using Modern Techniques.
OBJECTIVE
To investigate the effects of age on the clinical, functional, and radiographic outcomes of patients with proximal humerus fractures treated operatively with locking plates.


METHODS
Between February 2003 and July 2012, all patients who sustained a proximal humerus fracture who presented to our institution were enrolled into a database. Patients were followed up at 1, 6, 12, 26, and 52 weeks postoperatively with physical examination and radiographs. Validated functional outcomes scores were collected at 6 and 12 months. Complications were recorded as they occurred. Statistical analysis was conducted to assess for functional, physical, or radiographic differences between patients age younger than 65 and patients age 65 or older.


RESULTS
Of the 147 consecutive patients treated operatively for a proximal humerus fracture, 115 (78%) patients with an average follow-up of 16 months met the inclusion criteria for this study. The young cohort (patients < 65) included 70 patients with an average age of 53, whereas the elderly cohort (patients ≥ 65) included 45 patients with an average age of 73. The older cohort had significantly more women (P = .04), but there was no statistical difference in fracture type between the age groups. There were no differences in the radiographic measures of screw penetration, humeral head height, and neck-shaft angle between the age groups. There were no differences in physical examination scores between the age groups. There were no significant differences in functional outcomes or complication rates between the age groups.


CONCLUSIONS
Treating proximal humerus fractures operatively with locked plates can overcome the challenges of poor bone quality that often occur with increasing age. Age should not play a significant role in the decision-making process for treating proximal humerus fractures that would otherwise be indicated for surgical fixation.
Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY, USA.
Brandon S
BS
Shulman
Crispin C
CC
Ong
James H
JH
Lee
Raj
R
Karia
Joseph D
JD
Zuckerman
Kenneth A
KA
Egol
age; elderly; locking plate; proximal humerus fracture