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Review paper

A new plate design to treat displaced 3-4 parts proximal humeral fractures in comparison to the most tested and used plate: clinical and radiographic study

By
Giuseppe Rollo ,
Giuseppe Rollo

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Giuseppe Porcellini ,
Giuseppe Porcellini

Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Modena, Italy

Roberto Rotini ,
Roberto Rotini

Shoulder and Elbow Unit, “Rizzoli” Orthopaedic Institute, Bologna, Italy

Michele Bisaccia ,
Michele Bisaccia

Division of Orthopaedics and Trauma Surgery, University of Perugia, “S. Maria della Misericordia” Hospital, Perugia, Italy

Paolo Pichierri ,
Paolo Pichierri

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Paolo Paladini ,
Paolo Paladini

Shoulder and Elbow Unit, “D. Cervesi” Hospital, Cattolica-AUSL della Romagna, Ambito Rimini, Italy

Enrico Guerra ,
Enrico Guerra

Shoulder and Elbow Unit, “Rizzoli” Orthopaedic Institute, Bologna, Italy

Enio De Cruto ,
Enio De Cruto

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Raffaele Franzese ,
Raffaele Franzese

Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Naples, Italy

Predrag Grubor ,
Predrag Grubor

School of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina

Valerio Pace ,
Valerio Pace

Division of Orthopaedics and Trauma Surgery, University of Perugia, “S. Maria della Misericordia” Hospital, Perugia, Italy

Luigi Meccariello Orcid logo
Luigi Meccariello
Contact Luigi Meccariello

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Abstract

Aim
Proximal humeral fractures are common and most complex patterns currently represent a challenge for surgeons. Difficulties in obtaining good anatomical reduction (particularly of great tuberosity) often lead to unsatisfactory results; choices often fall onto prosthesis implantation against fixation options. The aim of this study was to compare a new design of proximal humeral plate with the most used plates in the treatment of these injures by analysing outcomes and complications. Methods
Two hundred patients with proximal 3 or 4 parts humeral fracture were enrolled (Neer 3-4). First group treated with PGR Plate composed of 98 patients. Second group treated with Philos Plate composed of 102 patients. Evaluation criteria were Non-Union Scoring System, duration of surgery, complications, objective quality of life and elbow function (Constant Shoulder Score), subjective quality of life and elbow function (Oxford Shoulder Score), post-op radiographs, centrum collum diaphyseal angle. Evaluation endpoint was 12 months.
Results
There was no statistically significant difference between the groups with regard to the selected evaluation parameters. Achievement of good shoulder range of motion and ability to perform normal daily living activities was obtained in both groups. The PGR had a positive impact on treatment results of varuspattern of proximal humeral fractures.
Conclusions
The PGR allowed good clinical and radiographic results in the treatment of proximal humeral fractures, comparable to those obtained with Philos. Also, PGR had the advantage to aid and keep the anatomical reduction of patterns of fracture involving the greater tuberosity.

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