title: Long-term functional outcomes (median 10 years) after locked plating for displaced fractures of the proximal humerus.
abstract: BACKGROUND
  Locked plating has become an accepted treatment for displaced fractures of the proximal humerus. However, to our knowledge, long-term outcomes have not been reported.
  
  
  METHODS
  Between February 2002 and March 2004, 121 patients with displaced proximal humeral fractures were treated by open reduction and locking plate fixation. Forty-three patients were available for 10-year (95% confidence interval [CI], 9.8-10.1) follow-up, including Constant score (CS), Disabilities of the Arm, Shoulder and Hand score, and Short Form 36 questionnaire.
  
  
  RESULTS
  Of 43 patients (72% women; mean age at time of fracture repair, 58.2 years; 95% CI, 54.2-62.2), the absolute CS 10 years after surgery was 75.3 (95% CI, 69.2-81.4). The normalized CS was 88.4 (95% CI, 81.7-95.1), and the CS in percentage to the contralateral side (%CS) was 83.7 (95% CI, 78.5-88.9). In contrast, at 1 year, the CS was 73.9 (95% CI, 67.8-80.2, P = .774), the normalized CS was 87.2 (95% CI, 80.4-94.0; P = .765), and the %CS was 78.7 (95% CI, 71.5-85.8; P = .355). The CS at 10 years correlated with the CS at 1 year after surgery (r = 0.460; P < .01) and with patient gender (r = -0.424; P < .01), and it strongly correlated with patient age (r = -0.545; P < .001).
  
  
  CONCLUSIONS
  Ten years after locked plating of displaced proximal humeral fractures, patients show good to excellent outcomes in the majority of cases with no relevant decline compared with the shoulder function 1 year after surgery. However, poor long-term outcome is seen in 16% of patients and relates to a low CS 1 year after surgery. Thus, patients developing poor long-term outcomes may be identified at an earlier stage.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany. Electronic address: Ben.Ockert@med.uni-muenchen.de.
authors.forename: Ben
authors.initials: B
authors.lastname: Ockert
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Siebenbürger
authors.affiliation: Red Cross Hospital, Munich, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Kettler
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany; Sportsclinic Germany, Munich, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Braunstein
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Wolf
authors.initials: W
authors.lastname: Mutschler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: Constant score; Proximal humeral fracture; locked plating; long-term; loss of fixation; outcome