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Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Treatment of displaced proximal humerus fractures remains challenging. The introduction of locking plates has renewed interest in treating these fractures with joint-preserving techniques rather than hemiarthroplasty, but high complication rates are still reported. Avascular necrosis is not solely dependent on the initial fracture pattern, but can also result from intraoperative and postoperative vascular insults.

Method

We describe a technique to minimize disruption of humeral head blood supply and maximize fracture fixation. A total of 34 patients with complex proximal humerus fractures were treated with a locking plate and endosteal implant through an anterolateral approach and followed for an average of 66 weeks to determine the rates of avascular necrosis.

Results

No patient suffered complete osteonecrosis (0%) and only one patient suffered partial necrosis (2.8%) of the humeral head. The length of the posteromedial hinge was not predictive of this complication.

Conclusion

Use of the anterolateral approach and endosteal augment of a lateral locking plate can minimize avascular necrosis following proximal humerus fracture.

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Conflict of interest

The authors declare that they have no conflicts of interest related to this study.

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Authors and Affiliations

  1. Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY, USA

    Andrew S. Neviaser, Carolyn M. Hettrich, Joshua S. Dines & Dean G. Lorich

Authors
  1. Andrew S. Neviaser
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  2. Carolyn M. Hettrich
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  3. Joshua S. Dines
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  4. Dean G. Lorich
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Correspondence to Andrew S. Neviaser.

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Neviaser, A.S., Hettrich, C.M., Dines, J.S. et al. Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant. Arch Orthop Trauma Surg 131, 1617–1622 (2011). https://doi.org/10.1007/s00402-011-1366-6

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  • DOI: https://doi.org/10.1007/s00402-011-1366-6

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