Proximal periarticular locking plates in XXXX : functional outcomes.

@entity1 @entity174 @entity3138 @entity6342 @entity158 @entity2530
BACKGROUND: Some recent studies have asserted that locking plates do not provide adequate fixation of @entity6342 . The purpose of this study is to review our experience with proximal humeral locking plates, including complications, functional outcomes, and predictors of successful treatment. MATERIALS AND METHODS: At our institution, 45 @entity1 (46 shoulders) with displaced @entity6342 were treated with a proximal humeral locking plate over a 6-year period. @entity1 underwent standard surgical and rehabilitation protocols and were evaluated clinically with Disabilities of the Arm, Shoulder and Hand and American Shoulder and Elbow Surgeons standardized outcome measurements and range of motion at last follow-up. Radiographs obtained preoperatively, immediately postoperatively, and at final follow-up were evaluated for @entity174 type, union, and change in alignment. RESULTS: There were 43 @entity1 (44 shoulders) available for range-of-motion and functional outcome measures with an average follow-up of 34 months. Fracture types included 19 two-part, 21 three-part, 3 four-part, and 1 head-splitting @entity174 . The mean Disabilities of the Arm, Shoulder and Hand score was 11. The average American Shoulder and Elbow Surgeons score was 85. The average visual analog @entity158 score was 0.8. The average range of motion was as follows: elevation, 140  ; external rotation at side, 49  ; external rotation in abduction, 77  ; and internal rotation, @entity3138 . No @entity1 had evidence of screw cutout, varus collapse, or @entity2530 . One @entity1 required hardware removal. CONCLUSIONS: Displaced @entity6342 can be successfully fixed with locking plates when  attention is paid to anatomic reduction, proper plate placement below to the greater tuberosity to allow abduction, screws in the head with subchondral bone purchase, calcar screws from inferior-lateral to superior-medial and delaying shoulder motion until at least 2 weeks.
