title: Fixed-angle locking proximal humerus plate: an evaluation of functional results and implant-related outcomes.
abstract: BACKGROUND
  Displaced and unstable proximal humeral fractures are challenging injuries to treat. Proximal humeral locking plates are a recent development for the treatment of these complex fractures.
  
  
  METHODS
  Retrospective analysis of 23 patients with 23 proximal humeral fractures treated with the Synthes locking proximal humerus plate. These were Neer two-, three- and four-part fractures. Follow-up was at a mean of 22 months and included clinical assessment using the Constant score (CS) and the Short Form-12 health questionnaire. Radiographic assessment was performed to assess implant-related complication in relation to the initial fracture pattern and the presence of adequate medial support.
  
  
  RESULTS
  The mean CS for all patients was 60.4 (range, 29-85). The mean adjusted CS was 82% (range, 30-117), active forward flexion 127 degrees and the active abduction 115 degrees. Initial fracture pattern, the presence or absence of adequate medial support and age did not significantly influence the clinical scores. Complications included one infection, two cases of avascular necrosis, two cases of varus collapse with screw penetration and one non-union. The overall reoperation rate was 26%. There was an increased rate of complications in those with inadequate medial support (P = 0.0183) and a trend to higher complication rates in four-part fractures.
  
  
  CONCLUSIONS
  Using the locking proximal humerus plate for the treatment of proximal humeral fractures is an acceptable procedure with comparable outcomes with historical controls, but with a complication rate of 30%. More important than implant selection, however, is the ability to achieve a stable reduction with calcar support.
authors.affiliation: Barwon Orthopaedic Research Unit, The Geelong Hospital, Geelong, Victoria, Australia.
authors.forename: Ponnaren
authors.initials: P
authors.lastname: Pak
authors.forename: Kevin
authors.initials: K
authors.lastname: Eng
authors.forename: Richard S
authors.initials: RS
authors.lastname: Page
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: complications; locking plate; outcomes; proximal humerus fracture