IJSRP, Volume 3, Issue 12, December 2013 Edition [ISSN 2250-3153]
Dr Rajneesh Garg, Dr Renu Gupta
Background: Different operative techniques used for treating displaced proximal humeral fractures could result in malunion, non-union, osteonecrosis of humeral head, loosening of screw and loss of reduction particularly in comminuted and osteoporotic fractures. Locking compression plate (LPHP) has been proposed for open reduction and internal fixation of these fractures and is associated with less complication rate.
Materials and methods: Functional outcomes of 16 men and 14 women aged 18- 72 (mean 44.53) years who underwent locking compression plate fixation for proximal humeral fractures were observed after an average 12 months follow- up.
Results: According to constant score, 36.66% had excellent outcome, 46.67% had good functional outcome and 16.66% had moderate outcome. The shoulder range of movement was excellent in 11 (36.66%), moderate in 13 (43.33%), and poor in 6 (20%). In objective assessment it was observed that about 83% regain adequate power to perform activities of daily living and in subjective assessment it was found that 63.33% patients were able to perform activity of daily living without much problem. All fractures healed satisfactorily, except in one patient with a valgus 4-part fracture who had malunion. No wound infections, vascular injuries, avascular necrosis, or loss of fixation ensued. Two patients with axillary nerve palsy recovered spontaneously within 3 months.
Conclusions: Locking compression plate (LPHP) is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones in elderly patients, thus allowing early mobilization.