Clinical and radiologic results of open reduction and fixation withlocked plate screws in proximal humerus fracture–dislocation

Abstract

AimProximal fracture dislocations of the humerus are rarely seen in society compared to other fractures. In our study, we evaluated the clinical and radiological results of patients who underwent open reduction and locked plate–screw fixation with proximal humerus fracture–dislocation. MethodBetween January 2009 and January 2016, 17 patients were treated with open reduction and locking plate screws in the Department of Orthopedics and Traumatology at the Faculty of Medicine, Dicle University. Patients were divided into two groups according to age. Group 1 consisted of 6 patients over 65 years of age and the mean age was 77.5 (69-87). Group 2 consisted of 11 patients under 65 years of age and the mean age was 41.6 (24-60). Group 1 consisted of all female patients and Group 2 consisted of all male patients. Patient fractures were classified according to the Neer classification. Oxford Shoulder Scale, DASH Score, and Constant Murley Score were used in the clinical evaluation of the patients. Avascular necrosis phase was performed according to Cruess phase. ResultsThe mean follow-up period of the patients was 13.8 months (range 10-38). The mean duration of surgery was 1.11 days (range 0-4). According to the Neer classification, 11.8% of the cases were two-part fracture dislocation, 64.7% were three-part fracture dislocation, and 23.5% were four-part fracture dislocation. There was a statistically significant difference between Oxford and DASH scores in the clinical outcome according to age groups (P = .001, P = .049). Avascular necrosis was observed in 14 of 17 (82.3%) patients. Additional complications such as wound infection, nonunion were not observed. ConclusionIn proximal humerus fracture–dislocations, the first surgical choice should be open reduction and internal fixation in young patients, whereas internal fixation in addition to arthroplasty should be considered in elderly patients.

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