Treatment for displaced proximal humerus fractures: comparison of interlocking plate fixation versus minimal invasive techniques

Background and purpose

The functional results and the complications following interlocking plate fixation of displaced proximal humerus fractures should be evaluated and compared with those following minimal invasive fixation techniques.

Patients and methods

Fifty patients (30 women, 20 men, mean age 62.7 (18–91) years) were treated for a displaced proximal humerus fracture using an interlocking plate fixation (PHILOS^®) between 2003 and 2004. The mean follow-up time was 12 (9–36) months. Functional and radiographic results (Constant-Murley and Neer scores) were analyzed and compared with an equivalent historical control group of 53 patients operated for the same fracture types using minimal invasive techniques (K-wires and/or cannulated screws) between 1995 and 1997. According to the OTA/AO classification, there were 15 type A, 18 type B, and 17 type C fractures in the plate fixation group, and 23, 25, and 5 of these types in the control group, respectively.

Results

The mean Neer score was 85.9, the mean Constant-Murley score 84, whereas 82.4 and 75.4 for the control group, respectively. Good and excellent results were seen in 78 %, whereas in 70 % in the control group. The results were dependent upon the fracture’s type, sex, and patient’s age. Complications were seen in 9 patients, whereas in 16 patients in the control group.

Interpretation

Using an interlocking plate, the indication of fixation of displaced proximal humerus fractures had been expanded to type C fractures. The implant failure rate can be reduced. The functional results achieved are better compared with those following minimal invasive techniques.