Early results in the treatment of proximal humeral fractures with a polyaxial locking plate

Objectives

We report early results using a second generation locking plate, non-contact bridging plate (NCB PH^®, Zimmer Inc. Warsaw, IN, USA), for the treatment of proximal humeral fractures. The NCB PH^® combines conventional plating technique with polyaxial screw placement and angular stability.

Design

Prospective case series.

Setting

A single level-1 trauma center.

Patients

A total of 50 patients with proximal humeral fractures were treated from May 2004 to December 2005.

Intervention

Surgery was performed in open technique in all cases.

Main outcome measures

Implant-related complications, clinical parameters (duration of surgery, range of motion, Constant–Murley Score, subjective patient satisfaction, complications) and radiographic evaluation [union, implant loosening, implant-related complications and avascular necrosis (AVN) of the humeral head] at 6, 12 and 24 weeks.

Results

All fractures available to follow-up (48 of 50) went to union within the follow-up period of 6 months. One patient was lost to follow-up, one patient died of a cause unrelated to the trauma, four patients developed AVN with cutout, one patient had implant loosening, three patients experienced cutout and one patient had an axillary nerve lesion (onset unknown). The average age- and gender-related Constant Score (n = 35) was 76.

Conclusions

The NCB PH^® combines conventional plating technique with polyaxial screw placement and angular stability. Although the complication rate was 19%, with a reoperation rate of 12%, the early results show that the NCB PH^® is a safe implant for the treatment of proximal humeral fractures.