Locked plating : clinical considerations

Between April 2006 and March 2007, 41 patients with displaced comminuted fractures of the humeral proximal third, were surgically treated. In 12 cases (29.3%) the fracture was classifiable to a 2-part fracture according to Neer classification; in 21 cases to a 3-part fracture (51.2%) and finally, in 8 cases, to a 4-part fracture (19.5%). In all cases, interfragmentary stabilization was achieved by means of new-concept AxSOS plates, a locking plate system with angular stability. With the patient in a beach-chair position and the upper limb initially in 0 degrees of abduction, an anterolateral modified surgical access was used to the proximal humerus, fitted to assure the safety of the axillary nerve and the posterior circumflex artery. At 6-months follow up, the Constant score was 71 points out of a total of 100. Mean VAS score was 13.5 points out of a maximum score of 15. The assessment of quality of life was 6.2 points out of a maximum of 10 and functional recovery was extremely satisfying.