title: [Corrective osteosynthesis of proximal humeral fractures. Technique and prospective results].
abstract: BACKGROUND
  Fracture sequelae of proximal humeral fractures arise following nonoperative and operative forms of treatment. Due to a painful restricted range of motion, in most cases shoulder prostheses are implanted. There is a need for joint-preserving alternatives especially for younger patients.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the surgical techniques and prospective results of fracture sequelae of proximal humeral fractures following corrective osteosynthesis.
  
  
  METHODS
  A total of 11 patients (4 female) with an average age of 53 years (range 29-71 years) and a mean follow-up of 19.5 months were included prospectively. The preoperative and postoperative ranges of motion of the affected shoulder were compared by statistical means. At the time of follow-up the constant score (CS), the simple shoulder test (SST) and the simple shoulder value (SSV) were assessed.
  
  
  RESULTS
  Fracture sequelae were classified as type II in four patients, as type III in two and as type IV in five patients using the Boileau classification. Shoulder flexion (p = 0.006), abduction (p = 0.003) and external rotation (p = 0.02) improved significantly in the postoperative course. The mean age and gender-adapted CS was 74.8 ± 19.9 % at the time of follow-up, 10.1 out of 12 points were reached in the SST and the mean SSV was 77 %.
  
  
  CONCLUSIONS
  Corrective osteosynthesis of fracture sequelae (Boileau types II-IV) of proximal humeral fractures appears to be a good alternative to implantation of shoulder prostheses, especially in younger patients (< 60 years of age).
authors: Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Humboldtstr. 5, 30169, Hannover, Deutschland, helmut.lill@ddh-gruppe.de.
authors: H
authors: H
authors: Lill
authors: C
authors: C
authors: Voigt
authors: G
authors: G
authors: Jensen
authors: M
authors: M
authors: Warnhoff
authors: J C
authors: JC
authors: Katthagen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012784:Shoulder Fractures / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome
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