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[EFFECTIVENESS OF OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING ANATOMICAL PLATE FOR TREATING VALGUS IMPACTED PROXIMAL HUMERUS FRACTURE].

OBJECTIVE
To investigate the effectiveness of open reduction and internal fixation with locking anatomical plate for treating valgus impacted proximal humerus fracture.


METHODS
A retrospective analysis was made on the clinical data of 38 patients with valgus impacted proximal humerus fracture who underwent open reduction and internal fixation with locking anatomical plate between January 2009 and January 2014. There were 25 males and 13 females, aged from 47 to 63 years (mean, 52.3 years); the left and the right sides were involved in 18 and 20 cases, respectively. The causes of fracture included high falling injury in 10 cases, traffic accident injury in 15 cases, and falling injury in 13 cases. The time between injury and operation was 5-10 days (mean, 7.5 days). The collodiaphyseal angle was 160-200 degrees (mean, 176 degrees) on X-ray films.


RESULTS
All incisions healed by first intention, and there was no early complication related to operation. All these patients were followed up 12-30 months (mean, 18 months). X-ray film showed that clinical healing time of fracture was 10-16 weeks after operation (mean, 12 weeks); at 12 months after operation, the collodiaphyseal angle recovered to 120-145 degrees (mean, 135 degrees). During follow-up, no loss of fracture reduction and no loosening of internal fixation were observed. At 10-12 months, osteonecrosis of the humeral head occurred in 3 cases (7.9%), including 2 cases of Cruess stage III and 1 case of Cruess stage IV. At last follow-up, the Constant shoulder joint scores were 56-95 (mean, 82.6); the results were excellent in 10 cases, good in 15 cases, fair in 9 cases, and poor in 4 cases, with an excellent and good rate of 66%. Visual analogue scale (VAS) scores were 0-6 (mean, 0.9).


CONCLUSION
It can achieve a comparatively satisfactory clinical result to use open reduction and internal fixation with locking anatomical plate for treating valgus impacted proximal humerus fracture.