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Clin Shoulder Elbow > Volume 20(4); 2017 > Article
Clinics in Shoulder and Elbow 2017;20(4):217-221.
DOI: https://doi.org/10.5397/cise.2017.20.4.217    Published online December 31, 2017.
Internal Fixation with a Locking T-Plate for Proximal Humeral Fractures in Patients Aged 65 Years and Older
Jae Kwang Yum, Min Kyu Seong, Chi Woon Hong
Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea. Shoulder@paik.ac.kr
Received: 22 August 2017   • Revised: 30 October 2017   • Accepted: 31 October 2017
Abstract
BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older.
METHODS
From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients.
RESULTS
The mean flexion was 155.0° (range, 90°?180°), the mean internal rotation was T8 (range, T6?L2), and the mean external rotation was 66.8° (range, 30°?80°). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was 131.4° at the 6-month follow-up. According to the Paavolainen method, “good” and “fair” radiographic results each accounted for 38 and 9 of the total patients, respectively.
CONCLUSIONS
We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.
Key Words: Proximal humerus; Osteoporotic fractures; Locking T-plate; Internal fixation


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