Treatment for displaced proximal humerus fractures: comparison of interlocking plate fixation versus minimal invasive techniques.

Background And Purpose: The functional results and the complications following interlocking plate fixation of displaced proximal humerus fractures should be evaluated and compared with those following minimal invasive fixation techniques.

Patients And Methods: Fifty patients (30 women, 20 men, mean age 62.7 (18-91) years) were treated for a displaced proximal humerus fracture using an interlocking plate fixation (PHILOS®) between 2003 and 2004. The mean follow-up time was 12 (9-36) months. Functional and radiographic results (Constant-Murley and Neer scores) were analyzed and compared with an equivalent historical control group of 53 patients operated for the same fracture types using minimal invasive techniques (K-wires and/or cannulated screws) between 1995 and 1997. According to the OTA/AO classification, there were 15 type A, 18 type B, and 17 type C fractures in the plate fixation group, and 23, 25, and 5 of these types in the control group, respectively.

Results: The mean Neer score was 85.9, the mean Constant-Murley score 84, whereas 82.4 and 75.4 for the control group, respectively. Good and excellent results were seen in 78%, whereas in 70% in the control group. The results were dependent upon the fracture's type, sex, and patient's age. Complications were seen in 9 patients, whereas in 16 patients in the control group.

Interpretation: Using an interlocking plate, the indication of fixation of displaced proximal humerus fractures had been expanded to type C fractures. The implant failure rate can be reduced. The functional results achieved are better compared with those following minimal invasive techniques.