title: Clinical outcomes of allograft with locking compression plates for elderly four-part proximal humerus fractures.
abstract: BACKGROUND
  The aim of this study is to explore the clinical outcomes of anatomical allograft or fibula shaft augmentation with locking compression plates (LCPs) in elderly patients with four-part proximal humeral fracture (PHF).
  
  
  METHODS
  A total of 22 elderly patients with four-part PHF underwent allograft augmentation with LCPs for treatment. Among them, 7 cases received anatomical allograft and 15 patients received fibula shaft. Constant-Murley score (CMS), the disability of the arm, shoulder and hand (DASH) score, and subjective ratings, radiographic imaging, range of motion (ROM), and complications were recorded as postoperative evaluations.
  
  
  RESULTS
  Although the ROM and strength were considerably limited compared with the normal side, there were no significant differences in pain and daily activity between the unaffected and affected sides at the last follow-up according to the CMS. Additionally, no significant differences were found in the subjective ratings and CMS and DASH scores between the patients augmented with fibular shaft and anatomical allograft. Among the 15 patients who received fibular shaft, one case developed avascular necrosis (AVN) and screw cutout, but satisfactory outcomes were obtained after removal of implant. Besides, varus displacement occurred in one case, the patient acquired good function without revision. There were no infection, bone nonunion, and hardware-related complications occurred in any case.
  
  
  CONCLUSIONS
  Both anatomical allograft and fibula shaft with LCPs showed relatively good clinical outcomes for elderly patients with four-part PHF.
authors.affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. chenhua0270@126.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. jixinran@gmail.com.
authors.forename: Xinran
authors.initials: X
authors.lastname: Ji
authors.affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. zhangqun301@sina.com.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. liangxd301@126.com.
authors.forename: Xiangdang
authors.initials: X
authors.lastname: Liang
authors.affiliation: The Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. tangpf301@163.com.
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D019245:Compressive Strength; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome