Publication:

Results of surgical management of unstable proximal humeral fractures by proximal humeral locking plate

Background Unstable fractures of the proximal humerus present a significant surgical challenge despite the variety of treatment options available. One effective surgical method for managing these fractures is the use of a proximal humerus locking plate. This approach provides stability and support to the fracture site, facilitating proper healing and potentially improving patient outcomes. The aim of this study was to evaluate the outcome of treatment of unstable proximal humeral fractures with proximal humeral locking plate.

Methods This prospective study was conducted in the the Department of Orthopedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka, Bangladesh during the period from January 2009 to December 2010. A total of 100 patients aged over 18 years were included in the study. Patients with open, pathological and ipsilateral distal fractures in the same limb were excluded from the study.

Results The mean age of patients with unstable proximal humerus fractures was 41.53 years, ranging from 23 to 78 years. Most patients were male and primarily in business occupations. Fracture types included three-part fractures (53%), four-part fractures (7%), and fracture dislocations (40%). The mean time to plate fixation was 18 days, with a range of 2 to 78 days. High-velocity accidents caused 93% of injuries. Complications included avascular necrosis (7%), screw loosening (7%), and subacromial impingement (13%), with no reoperations needed.

Conclusions The result of the study demonstrates that the proximal humeral locking plate provides sufficient fracture stabilization in the treatment of unstable proximal humeral fractures.