Die winkelstabile Platte zur Behandlung der 3- und 4-Fragmentfraktur am proximalen Humerus

Background

The proximal humeral fracture depicts one of the most frequent fractures in traumatology in general and especially in gerontotraumatology. The standard procedure of open reduction and fixation with a locking plate is associated with high complication rates.

Material and methods

A total of 34 patients with a complication after treatment with a locking plate in 2007 and 2008 at our clinic were examined with a mean follow-up of 23 months. Patients without complications (n=34) represented the control group.

Results

The examination revealed a rate of 50% of undesired events, mainly screw perforations (76%). If a complication occurred, the functional result was poor (Constant Murley Score, CMS, 43, age-adapted CMS 53), the revision rate was high and the patient satisfaction was low. A statistically significant, negative predictive factor for a complication was the 4-fragment fracture and multimorbidity, especially neurologic and psychiatric diseases, e.g., dementia.

Conclusion

Older patients with a 4-part fracture and multiple secondary diagnoses like dementia should be treated with a primary prosthesis.