Helical Plating for Fractures of the Proximal Humeral Shaft

Abstract

Purpose:To evaluate the effectiveness of internal fixation with a helical plate for displaced proximal humeral shaft fractures by analyzing the clinical outcomes of patients. Materials and Methods: Fourteen displaced fractures of the proximal humeral shaft were treated by open reduction and internal fixation (ORIF) or by minimally invasive plate osteosynthesis (MIPO) with the use of helical locking compression plates. We evaluated the adequacy of reduction, time-to-fracture healing, range of motion of the shoulder, and postoperative complications. The functional outcome of the shoulder was evaluated using a Constant-Murley shoulder score. Results: Anatomical reduction of the fracture was obtained in nine cases treated by ORIF, and anatomical alignment was obtained in five cases treated by MIPO. All fractures were healed in an average of 14.9 weeks. The active range of motion of the shoulder was fully recovered in five cases, and restricted in nine cases, at around 12 months after surgery. The mean Constant-Murley shoulder score was 87.4 points, at around 12 months after surgery. There were no major complications, such as neurovascular injury, infection, loss of fixation, and nonunion. Conclusion: Helical locking compression plating for proximal humeral shaft fractures is a safe and effective surgical method in obtaining satisfactory fracture healing and functional outcome because it provides stable fixation and avoids complications related with lateral plating.

Controlled bending of proximal femoral nails used in fractures of bowed femurs: biomechanical study with clinical application

“…Applying a long plate covering the entire length of the femoral bone has also been suggested, but a gap between the lateral cortex and the plate often forms owing to difficulties in bending the plate appropriately, which may result in plate irritation [2,17]. Additionally, plate application may require abundant soft tissue dissection, which may inhibit endochondral ossification, thereby leading to fixation failure [18,19].…”