Evaluation of Open Reduction and Internal Fixation of Proximal Humerus Fractures Using a Locking Plate with Smooth Pegs - A Retrospective Study

Overview

Journal Shoulder Elbow

Date 2020 Apr 10

PMID 32269600

Citations 1

Authors

Frida Hansson

Magdalena Riddar

Anders Ekelund

Affiliations

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Abstract

Background: Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate).

Method: Eighty-two patients with displaced proximal humeral fracture classified with 2-4 fragments (Neer's classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery.

Results: A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen.

Conclusions: Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.

Citing Articles

Results of open reduction and internal fixation of proximal humerus fractures using a proximal humeral plating system with smooth pegs.

Kjaer C, Hillblom M, Lenholm E, Bostrom Windhamre H, Ekelund A Shoulder Elbow. 2025; 17585732241309582.

PMID: 39830195 PMC: 11736732. DOI: 10.1177/17585732241309582.

Pegs not superior to screws for fixation of fractures of the proximal humerus.

Bones I, Karlberg A, Liljeholm M, Fraser A, Madsen J, Fjalestad T J Orthop Surg Res. 2022; 17(1):66.

PMID: 35109905 PMC: 8812225. DOI: 10.1186/s13018-022-02947-3.

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