The Outcome of Proximal Humeral Locking Plates in the Management of Three and Four Part Proximal Humeral Fractures in Special Cohort of Young Patients in High Velocity Trauma

Abstract

Background: Locking plate fixation provides satisfactory outcome following proximal humerus fractures. None of the<br />previous studies selectively evaluate the outcome in young patients. This study evaluates outcome of locking plate<br />system in the treatment of acute three- and four-part fractures in young patients.<br />Methods: In this prospective study we included all patients who were less than 60 years, involved in high velocity<br />trauma, had proximal humerus comminuted three part and four part fractures and were operated using locking plate<br />at our centre, between August 2011 to August 2015. All the patients were followed up regularly. Assessment was done<br />clinically using Constant and Murley scoring system and radiologically using signs of healing in the form of callus<br />formation and cortical continuity.<br />Results: Twenty-five eligible patients were operated during the study period. All patients were involved in motor vehicle<br />collision. Average age of our patients was 41.2. The average duration of follow-up was 18.2 months(8 months to 27<br />months). 24 out of 25 fractures united clinically and radiologically at three months' follow-up. Average Constant and<br />Murley score at final follow-up was 78.52. The results were excellent to good in 15 patients, fair in five patients and poor<br />in five patients. Overall complication rate was 24%. Majority of them (20%) were restriction of movements of shoulders.<br />None of our patients needed reoperation.<br />Conclusion: Locking plate system, in three part and four part proximal humerus fractures in young patients, provides<br />secure and stable fracture fixation for early mobilization. Early results with locking plate system were promising in<br />younger patients. In these patients, locking plate system has definite role to preserve the humeral head and there by<br />maintain the functional activity level.