The use of locking plates in proximal humerus fractures-functional outcome based on age and fracture pattern

Abstract

Background: Proximal humerus fractures accounts for 4-5% of all fractures. This is the third most common fracture in the elderly population. Surgical treatment is advised for displaced proximal humerus fractures. This study was done to evaluate the functional outcome of fractures operated with locking plates and to evaluate any significant difference of outcome present between age (< 60 years and > 60 years) and fracture pattern (AO Type A, B, C). Materials and methods: This is a Prospective study conducted at Government Kilpauk Medical College Hospital. 25 cases of proximal humerus fractures operated with proximal humerus locking plates. Post operatively functional outcome was evaluated with Constant Murley Shoulder score and radiological followup. Results: In our study, 14 cases were < 60 years and 11 cases were > 60 years. The mean constant score was 86.75 and 67.1 for < 60 and > 60 years respectively and it was statistically significant. The difference in the functional outcome of three fracture types was statistically significant with a p value of 0.048. Conclusion: Proximal Humerus Locking Plate is the implant of choice for treating displaced proximal humerus fractures. It provides stable internal fixation, allows early mobilisation and prevents secondary loss of fixation. The functional outcome was decreased in elderly individuals when compared to younger individuals. More complex initial fracture patterns have decreased functional outcome postoperatively, hence adequate stable fixation and appropriate physiotherapy and rehabilitation protocols should be followed to achieve optimal functional outcome.