title: EVALUATION OF THE COMPLICATIONS OF SURGICAL TREATMENT OF FRACTURES OF THE PROXIMAL EXTREMITY OF THE HUMERUS USING A LOCKING PLATE.
abstract: OBJECTIVE
  To evaluate the complications from surgical treatment using a locking plate among patients with fractures of the proximal extremity of the humerus.
  
  
  METHODS
  Between July 2004 and December 2009, 56 patients with fractures of the proximal extremity of the humerus were treated using the PHILOS(®) plate. There were 19 male patients and 37 female patients, with a mean age of 62 years (range: 30 to 92 years). All the cases had a mean postoperative followup period of 12 months. Thirteen fractures were classified as presenting in two parts, 28 as three, eight as four and seven as epiphyseal fractures.
  
  
  RESULTS
  Among the patients operated, 26 were considered to have achieved excellent results, twelve good, ten fair and eight poor, according to the UCLA score. Thirty complications occurred in 20 patients (35.7%), among which the most frequent complication was inadequate reduction of the fracture, which occurred in eight cases. Subacromial impact, caused by the plate, occurred in seven cases, while inadequate fixation occurred in six cases. Other complications such as pseudarthrosis, adhesive capsulitis, avascular necrosis, loss of varus reduction and infection were also seen.
  
  
  CONCLUSIONS
  The functional results from treating fractures of the proximal extremity of the humerus using a locking plate depended on correct anatomical reduction of the fracture and stable fixation of the implant. Complications still occur frequently, particularly because of intraoperative technical difficulty, fracture severity and possible inexperience of the surgeon.
authors.affiliation: Assistant Professor and Head of the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Alberto Naoki
authors.initials: AN
authors.lastname: Miyazaki
authors.affiliation: Resident in the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: José Renato Depari
authors.initials: JR
authors.lastname: Estelles
authors.affiliation: Assistant Professor and Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fregoneze
authors.affiliation: Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Pedro Doneux
authors.initials: PD
authors.lastname: Santos
authors.affiliation: Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Luciana Andrade
authors.initials: LA
authors.lastname: da Silva
authors.affiliation: Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: do Val Sella
authors.affiliation: Trainee in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Fábio Eduardo
authors.initials: FE
authors.lastname: Ishioka
authors.affiliation: Trainee in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: João Polydoro
authors.initials: JP
authors.lastname: Rosa
authors.affiliation: Adjunct Professor, Academic Consultant and Member of the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Sergio Luiz
authors.initials: SL
authors.lastname: Checchia
keywords: Bone Plates; Fracture Fixation, Internal; Shoulder Fractures