Advertisement

Proximal Humeral Locking Plates for Displaced Fractures of the Proximal Humeral Humerus

  • Robert J. NeviaserEmail author
Chapter

Abstract

Many displaced proximal humeral fractures are amenable to open reduction and fixation with a proximal humeral locking plate. Critical to success of this technique are anatomic reduction of the humeral head, avoiding varus, tuberosity reduction so that its tip is just below the top of the head, placement of the plate so that its tip is below the tip of the tuberosity, and targeting screw placement into the regions of the humeral head with the documented highest bone mineral density and resistance to screw pullout. Delaying postoperative shoulder motion until at least 2 weeks is essential for avoiding complications.

Keywords

Rotator Cuff Great Tuberosity Proximal Humeral Fracture Axillary Nerve Deltopectoral Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Aguedelo J, Schurmann M, Stahel P, et al. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma. 2007;21:676–81.CrossRefGoogle Scholar
  2. 2.
    Neer II CS. Displaced proximal humeral fractures. Part I. Classification and evaluation. J Bone Joint Surg Am. 1970;52:1077–89.PubMedGoogle Scholar
  3. 3.
    Hepp P, Thepold J, Voight C. The surgical approach for locking plate osteosynthesis of displaced proximal humerus fractures influences the functional outcomes. J Shoulder Elbow Surg. 2008;17:21–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Huffman GR, Itamura JM, McGarry MH, Long D, Gililland J, Tibone JE, Lee TQ. Biomechanical assessment of inferior tuberosity placement during hemiarthroplasty for four part proximal humeral fractures. J Shoulder Elbow Surg. 2008;17:189–95.PubMedCrossRefGoogle Scholar
  5. 5.
    Hettrich CM, Neviaser A, Beamer BS, Paul O, Helfet DL, Lorich DG. Locked plating of the proximal humerus using an endosteal implant. J Orthop Trauma. 2012;26(4):212–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Solberg BD, Moon CN, Franco DP, Paiement GD. Surgical treatment of three and four-part proximal humerus fractures. J Bone Joint Surg Am. 2009;91:1689–97.PubMedCrossRefGoogle Scholar
  7. 7.
    Tingart MJ, Lehtinen J, Zurakowski D, Warner JP, et al. Proximal humeral fractures: regional differences in bone mineral density of the humeral head affect the fixation strength of cancellous screws. J Shoulder Elbow Surg. 2006;15:620–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Schulte LM, Mateini LE, Neviaser RJ. Proximal periarticular locking plates in proximal humeral fractures: functional outcomes. J Shoulder Elbow Surg. 2011;20:1234–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryGeorge Washington UniversityWashington, DCUSA

Personalised recommendations