[The cannulated blade plate 90 degrees for displaced proximal humeral fractures in elderly XXXX ].

@entity1 @entity281 @entity174 @entity39
Aim of the study was to analyse the results following osteosynthesis of proximal humerus @entity174 with cannulated blade plate 90 degrees (Synthes, Mathys Medizinaltechnik AG, Bettlach, Schweiz) in elderly @entity1 . Between 6/1998 and 12/1999 we treated 20 @entity1 (12 female, 8 male) > 65 years (65-92 y, 75 y) with the cannulated blade plate ( @entity174 type according to AO: 8 x 11-A3, 5 x 11-B1, 3 x 11-B2, 1 x 11-B3 und 3 x 11-C2). Regarding to mechanical and functional advantages we modified the 90 degrees angulation of the implant by bending intraoperatively up to 110-120 degrees. Early post-op physiotherapy was permitted. The radiological results of all @entity1 were evaluated and in 13 @entity1 a clinical follow-up (median 8 months) was obtained. According to the Constant-score 62 points on average were achieved, which corresponds to a satisfactory result (contralateral shoulder 92 points). Complications due to the implant were loosening of the blade plate in 3 cases (A3, B2, C2) and 1 perforation of the blade plate (C2). The consecutive reoperation consisted in a compound osteosynthesis with the blade plate (A3, B2) in 2 cases, a prosthetic replacement and a removal of the implant (C2) in 1 case respectively. Neither @entity281 nor avascular @entity39 occurred. The cannulated blade plate 90 degrees represents a justified alternative in the treatment of displaced @entity174 of the proximal humerus in elderly @entity1 . Commendable indications are @entity174 types A and B according to AO with stable fixation of the blade plate in the humeral head, which allow early physiotherapy and avoid an alteration of the rotator cuff. @entity174 tend to complications (2/3).
