Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2015 , Vol 6, Issue 1
The Impact of Age, Gender and Fracture Comminution On The Shoulder Function In 3 and 4 Proximal Humeral Fractures Treated With Locking Plate
Yunus Demirtaş, Serdar Yılmaz, Alper Deveci, Murat Gülçek, Özdamar Fuad Öken, Ahmet Özgür Yıldırım, Sualp Turan, Ahmet Uçaner
Ankara Numune Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye Purpose: We evaluated the relationship between age, fracture communition and the gender with the functional results in patients with three or four-part fractures of the proximal humerus treated with locking plate.

Patients and Method: We retrospectively evaluated 36 patients who were treated with anatomic locking plate for comminuted proximal humeral fracture. The mean age of patients was 62.2 (range 28-81). There were 16 female, 20 male patients. 21 patients had three-part fractures, 15 patients had four-part fractures. The patients were divided into 2 groups as follows, below 60 years old as Group A and over 60 years as Group B. The patients were called for the last control to check the state of the fracture radiographically and clinically. The mean follow-up time was 31.1 months (range 14-56 months). Mann-Whitney U test was performed to compare the functional state and age and the fracture comminution.

Results: All of the patients had fracture union. Two patients had superficial infection healed with antibiotic treatment, 3 patients had partial avascular necrosis, 5 patients had varus malalignment, 2 patients had screw migration, 2 patients had impingement syndrome. The mean Constant score was 71.75±10,6 (range 48-98). The functional results of Group A was higher than Group B independent of fracture comminution (p<0.001). Also the functional results of three-part fractures was higher than four-part fractures (p=0.04). There was no difference in the functional results between male and female patients (p=0.091).

Conclusion: The anatomic locking plate is an effective fixation method in three- and four-part proximal humeral fracture. But the shoulder function deteriorating with advanced age and fracture comminution. Keywords : proximal humeral fracture, locking plate, osteopenia, complication, advanced age