Complications in locking plate treating proximal humeral fractures

Objective To discuss complications in locking plate treating displaced proximal hu-meral fractures and explore preventive methods. Methods The study involved 92 patients who were treated with open reduction and internaI fixation with Locking plate from September 2004 to June 2007 and followed up for average 15.2 months(6-36 months).,There were 78 fresh fractures and 14 delayed ones.The average age of the patients was 47.7 years(17-83 years).American Shoulder and Elbow Surgeons Form(ASES)score,Constant-Murley score,University of California-Los Angels scoring system(UCLA) score and Simple Shoulder Test(SST)were used to evaluate the clinical results and observe range of mo-tion,recovery of pain and complications at the latest follow up.In the meantime.we observed the differ-ence of complications in different age,Sex,fracture side,operation time,injury causes,combined injury and fracture tvpe and compared the elinieal results between the patients with complications and those with-out. Results The average forward flexion wag(148.9 ±17.3)°(90°-170°).average external rota-tion up to(29.3 ±15.0)°(0°-70°)and average internal rotation reached T9(T4-L5).The mean VAS score was for(0.9 ±1.1)points(0-5 points).the mean ASES for(86.4 ±13.0)points(52-100points),the mean Constant score for(87.5±10.6)points(55-100 points),the mean UCLA for(30.2±4.0)points(18-35 points)and the mean positive answer of SST for 9.6(4-12).There were 17 pa-tients with complications.with incidence rate of 18.5%.As for incidence rate of complication.there was no statistical difierence upon different sex,time from injury to operation,injury side,combined injury,injury cause,fracture type or fixation type.However,there wag significant difierence in aspect of difierent ages.with incidence rate of complication for 25.5%in patients younger than 50 years old and 8.1% in those older than 50 years old(P＜0.05).Compared with non-complication group,complication group showed significant less extemal rotation and Constant-Murlev and UCLA functional score(P＜0.05).Conclusions Locking plate is a reliable method for displaced proximal humeral fractures.but there still with indication control and appropriate surgical technique,luring the whole procedure so as to reduce inci-dence rate of compl ication as possible. Key words: Shoulder fractures;  Fracture fixation,internal;  Complications