Clinical Application Of LCP In Treatment Of Middle-Aged And Senile Patients' Proximal Humeral Fracture

Objective Fractures of the proximal humerus are common and can have a profound effect on the quality of life of patients. Proximal humeral fractures are the more displaced and comminuted types. In addition to the increased fracture severity, fracture treatment is made more difficult due to the patient population being more elderly and osteoporotic . If patients are not treated properly, It can often causing pain ,limited mobility or other complications.This study is to evaluate the treatment effect of locking compression plate (LCP) for proximal humeral fractures . Methods Twenty-nine cases of middle-aged and senile patients' proximal humeral fractures treated with locking compression plate from July 2007 to July 2009 were studied retrospectively. in which 16 males and 13 females with age of 45～85 years old (mean 53.2years) . 16 of traffic accident .11 of tumble and 2 of pressing trauma .severn combined with primary osteoporosis.three cases with shoulder dislocation and two cases with humeral shaft fracture.According to the Neer classification, 7 cases were with two-part fractures, 12 with three-part fractures and 14 cases with four-part fractures .Reduction and fixation were done via deltopectoral interval approach. the locking plate was put on 10mm posterolateral to the intergroove of tuberosity, 5~10mm away from the tip of humeral greater tuberosity . Locking screws and unlocking screws were drilled into proximal and distal part of the fracture .Bonn graft was applied for 4 cases . Shoulder exercise should be performed passively three days after operation . One week after operation, active and passive shoulder exercise was done processingly. Results Twenty-five cases were followed up for 8 - 18 months, with an average of 13.5 months, all fractures were healed with average union period of 12.5 weeks. According to Neer shoulder score, the result was excellent in 13 cases, good in 8 and fair in 4,with excellent and good rate of 84%. Conclusion Application of locking proximal humerus plate may provide good fixed-effects. maintain an adequate ,stable fracture reduction to initiate early range of motion and reduce hardware complications in treatment of middle-aged and senile patients' Proximal humeral fractures . It is worthy of clinic application and further clinical study should be presented .