[The angle stable locking-proximal-humerus-plate (LPHP) for proximal humeral fractures using a small anterior-lateral-deltoid-splitting-approach - technique and first results]

Zentralbl Chir. 2004 Jan;129(1):43-8. doi: 10.1055/s-2004-44870.
[Article in German]

Abstract

The Locking-Proximal-Humerus-Plate (LPHP) was slided from proximally to distally through a small anterior-lateral-deltoid-splitting-approach following a closed reduction. Additional tension band wiring for the rotator cuff was fixed at the plate after screw insertion. The prospective study included 35 patients (age median: 63 years, range: 33-92; male: 13, female: 22) from 08/01-05/02. The follow-up period was set to 3 months postoperatively, whereas 29 patients were able to attend. The patient-group with 2-part fractures (n = 8) showed an average Constant score of 77.6 points (+/- 10.7, "good"), the patients with 3-part fractures (n = 16) an average score of 75.1 points (+/- 14.4, "good") and the patients with 4-part fractures (n = 5) an average score of 64.8 points (+/- 10. 4, "moderate"). Specific, approach-related problems were not observed. Almost all fractures revealed bony union during the first 3 months and only one loss of reduction was found. A screw loosening in 2 cases and a break of the plate in 3 cases were seen as implant related problems, and furthermore in 5 cases the screws placed in the humeral head were too long. Only one early re-osteosynthesis with the same plate was necessary due to an initial non-correct reposition. As demonstrated by these good short-term results, this technique seems to be a suitable procedure for displaced humeral head fractures.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Plates*
  • Bone Screws
  • Bone Wires
  • Equipment Failure
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Multiple Trauma / diagnostic imaging
  • Multiple Trauma / surgery
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / surgery
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Prospective Studies
  • Radiography
  • Range of Motion, Articular / physiology
  • Reoperation
  • Rotator Cuff / diagnostic imaging
  • Rotator Cuff / surgery
  • Shoulder Fractures / diagnostic imaging
  • Shoulder Fractures / surgery*
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery