title: Long contoured locking plate fixation of traumatic proximal humeral fractures with distal extension.
abstract: BACKGROUND
  There is a paucity of data available with respect to outcome on long contoured locking plate fixation for proximal humerus fractures with distal fracture extension.
  
  
  METHODS
  Thirty-four patients with traumatic proximal humerus fractures with distal extension underwent fixation with long contoured locking plates. Twenty-five patients (74%) were included in the study: one patient died, two patients had unrelated illnesses resulting in them being unable to complete follow-up assessment and six were lost to follow-up. Patients' case notes and radiographs were retrospectively reviewed, and patients were contacted to assess functional outcome using the Visual Analogue Scale (VAS) for pain, Disabilities of the Arm, Shoulder and Hand (DASH) score, Oxford Shoulder Score (OSS) and Stanmore Percentage of Normal Shoulder Assessment (SPONSA).
  
  
  RESULTS
  Mean follow-up was 27 months (range 11 months to 60 months). Mean pain at final follow-up was 3.6 [95% confidence interval (CI) = 2.5 to 4.8] with only four patients having residual pain greater than 5 on the VAS scale. Mean DASH score was 41.2 (95% CI = 32.0 to 50.4), mean OSS was 29.1 (95% CI = 24.3 to 33.9) and mean SPONSA was 63.9% (95% CI = 50.8 to 77.2). There was one wound infection. Three patients had non-unions that required bone grafting and revision internal fixation.
  
  
  CONCLUSIONS
  We feel long contoured locking plates represent a useful treatment option for complex proximal humerus fractures.
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Joby J
authors: JJ
authors: George Malal
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Alistair I W
authors: AI
authors: Mayne
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Faten
authors: F
authors: Arouri
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Ali M
authors: AM
authors: Noorani
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Matthew
authors: M
authors: Kent
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Matt
authors: M
authors: Smith
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Inigo
authors: I
authors: Guisasola
authors: Department of Trauma and Orthopaedics, Royal Liverpool & Broadgreen University Hospitals, Liverpool, UK.
authors: Peter
authors: P
authors: Brownson
keywords: Long contoured locking plates; PHILOS plate; proximal humerus fractures