First Experiences with the New Proximal Humerus Locking Compression Plate

Abstract

The new proximal humerus locking compression plate has been used in 29 fractures of the proximal humerus since 2001. Most of the fractures were B fractures, only three C fractures and one A fracture, which was a pseudarthrosis after conservative treatment were stabilised with this new implant. Stable osteosynthesis which allowed early range of motion exercises has been achieved in 22 cases. Partial metal removal because of loosening of screws had to be performed two times and a breakage of the plate occurred once. Deep infection that made complete removal of all implant necessary was observed in two cases. Because of the design of the plate, which is small and thin, but nevertheless stable because of locking screws there is less risk of humeral head necrosis, subacromial impingement and limitation in range of motion than in other plates.

Proximal humerus fracture - plate osteosynthesis - stability

References

• 1 Brooks C H, Revell W J, Heatley F W. Vascularity of the humeral head after proximal humeral fractures. An anatomical cadaver study.  J Bone Joint Surg [Br]. 1993;  75 132-136
• 2 Esser R D. Open reduction and internal fixation of three- and four-part fractures of the proximal humerus.  Clin Orthop. 1994;  299 244-251
• 3 Fankhauser F, Schippinger G, Seibert F J, Boldin C H, Peicha G. Indications and complications in percutaneous screwing of proximal humerus fractures.  Suomen Ortopedia ja Traumatologia. 2001;  24 357-360
• 4 Hintermann B, Trouillier H H, Schafer D. Rigid internal fixation of fractures of the proximal humerus in older patients.  J Bone Joint Surg [Br]. 2000;  82 1107-1112
• 5 Koval K J, Blair B, Takei R, Kummer F J, Zuckermann J D. Surgical neck fractures of the proximal humerus: a laboratory evaluation of ten fixation techniques.  J Trauma. 1996;  40 778-783
• 6 Liew A S, Johnson J A, Patterson S D, King G J, Chess D G. Effect of screw placement on fixation in the humeral head.  J Shoulder Elbow Surg. 2000;  9 423-426
• 7 Ruch D S, Glisson R R, Marr A W, Russell G B, Nunley J A. Fixation of three-part proximal humeral fractures: a biomechanical evaluation.  J Orthop Trauma. 2000;  14 36-40
• 8 Szyszkowitz R, Schippinger G. Fractures of the proximal humerus.  Unfallchirurg. 1999;  102 422-428
• 9 Szyszkowitz R, Seggl W, Schleifer P, Cundy P J. Proximal humeral fractures. Managment techniques and expected results.  Clin Orthop. 1993;  292 13-25