Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : Displaced proximal humeral fractures: an Indian experience with locking plates | Aggarwal et al. Journal of Orthopaedic Surgery and Research 2010 5 60 http content 5 1 60 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH RESEARCH ARTICLE Open Access Displaced proximal humeral fractures an Indian experience with locking plates Sameer Aggarwal Kamal Bali Mandeep S Dhillon Vishal Kumar Aditya K Mootha Abstract Background The treatment of displaced proximal humerus fractures especially in elderly remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant. Methods Over two and a half years 56 patients with an acute proximal humerus fracture were managed with locking plate osteosynthesis. 47 of these patients who completed a minimum follow up of 1 year were evaluated using Constant score calculation. Statistical analysis was done using SPSS 16 and a p value of less than was taken as statistically significant. Results The average follow up period was around months. Outcomes were excellent in 17 good in moderate in 34 while poor in . The Constant score was poorer for AO-OTA type 3 fractures as compared to other types. The scores were also inferior for older patients 65 years old . Complications included screw perforation of head AVN subacromial impingement loss of fixation axillary nerve palsy and infection. A varus malalignment was found to be a strong predictor of loss of fixation. Conclusion Locking plate osteosynthesis leads to satisfactory functional outcomes in all the patients. Results are better than non locking plates in osteoporotic fractures of the elderly. However the surgery has steep learning curve and various complications could be associated with its use. Nevertheless we believe that a strict adherence to the principles of locking plate use can ensure good result in such challenging fractures. .
