• Hongeun Cha, Ki-Beom Park, Seungbae Oh, and Jinyoung Jeong.
• Department of Orthopedic Surgery, Mirae Hospital, Busan, Republic of Korea.
• J Shoulder Elbow Surg. 2017 May 1; 26 (5): 781-785.

BackgroundThis study compared the radiologic outcome of fixation using locking plate only with fixation using locking plate with an endosteal strut allograft in the treatment of comminuted proximal humeral fracture.MethodsAmong 52 patients with comminuted proximal humeral fracture, 32 patients underwent fixation with locking plate only, and 20 patients underwent fixation using locking plate with an endosteal strut allograft. The strut allograft was inserted into the intramedullary cavity of the humerus to support the humeral head and fixed with the locking plate. Immediate postoperative radiologic findings were compared with those of 6 months or more after the surgery, and loss of anatomic fixation was defined if the varus malalignment of neck-shaft angle (NSA) was more than 5° or if the change of humeral head height (HHH) was more than 3 mm.ResultsIn the locking plate-only group, 22 of 32 patients (69%) showed the change in NSA of more than 5°, with an average of 10.2°. The HHH change in 20 patients (62.5%) was more than 3 mm, with an average of 4 mm. Among 20 patients who underwent locking plate with the endosteal strut allograft, the average NSA and HHH change was 3° and 1 mm, respectively. Varus malalignment was evident in 2 patients (10%). The HHH change was more than 3 mm in 1 patient (5%).ConclusionFixation using a locking plate with an endosteal strut allograft can be considered a reasonable option to maintain the anatomic reduction in elderly patients with comminuted proximal humeral fracture.Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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