XXXX in the elderly can be reliably fixed with a "hybrid" locked-plating technique.

@entity1 @entity2530 @entity174 @entity303 @entity158 @entity2693
BACKGROUND: Controversy exists regarding the best treatment of @entity174 in the elderly. Recent studies of open reduction and internal fixation have demonstrated high complication rates. QUESTIONS/PURPOSES: We asked whether (1) open reduction and internal fixation could be performed with low rates of immediate and delayed complications, (2) reduction of these @entity174 could be maintained over time by evaluating long-term radiographs and visual analog @entity158 scores, and (3) 6-week immobilization would lead to disabling @entity2693 by evaluating postoperative motion and functional scores. @entity1 AND METHODS: We retrospectively reviewed all 35 @entity1 older than 75  years with displaced @entity174 treated using a "hybrid" technique between 2002 and 2008. All @entity1 were immobilized for 6  weeks after surgery. Thirteen of the 35 @entity1 either died or developed severe @entity303 during followup. The analysis included 22 @entity1 followed a minimum of 1  year (mean, 3  years; range, 1-6.7  years). RESULTS: There were no early or late reoperations in this series. An acceptable reduction was achieved in 89% of the shoulders and maintained over time. All @entity174 healed. @entity2530 was noted on radiographs in 11% of the shoulders. Six weeks of immobilization did not lead to disabling @entity2693 . At most recent followup, mean active elevation was 141  , mean active internal rotation L1, mean active external rotation 36  , and mean American Society of Shoulder and Elbow Surgeons score 68. CONCLUSIONS: Utilizing this approach, open reduction and internal fixation followed by 6-week immobilization results in a low rate of reoperation and good functional outcomes for elderly @entity1 with @entity174 . LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
