title: Analysis of Failure with the Use of Locked Plates for Stabilization of Proximal Humerus Fractures.
abstract: OBJECTIVE
  To evaluate factors associated with complications in a series of patients with proximal humerus fractures treated with locked plating.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Level 1 Trauma Center.
  
  
  METHODS
  A retrospective review was performed on patients older than 18 years of age treated with a locked plate for a proximal humerus fracture between June 2007 and December 2011 in order to identify any factors associated with failure. Patients had a minimum of 6 months of clinical follow-up.
  
  
  RESULTS
  78 proximal humerus fractures in 78 patients were stabilized using a locked plate. Twenty-four patients were lost to follow-up, while 54 patients were available for 6-month minimum follow-up and comprised the study group. A healing complication occurred in 20 patients (37%) and consisted of loss of reduction (16), varus malunion (16), avascular necrosis (6) or implant penetration (1). Eleven of 54 patients (20%) required secondary surgery. Factors associated with a healing complication were number of fracture parts (p < 0.029), one or more comorbidities (p <0.016), three or more comorbidities (p < 0.038), and varus malreduction (p < 0.001).
  
  
  CONCLUSIONS
  An overall complication rate of 37% was found in patients stabilized using a locked plate after sustaining a proximal humerus fracture. Factors associated with healing complications included increased number of fracture parts, increasing number of comorbidities, and initial varus malreduction. Patient selection for locked plating after proximal humerus fracture should incorporate many factors with meticulous attention to surgical technique.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Silverstein
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Yirenkyi
authors.forename: George
authors.initials: G
authors.lastname: Haidukewych
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Koval
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation; D017102:Fracture Healing; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult