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Arm, Shoulder, and Hand

Solberg BD, Moon CN, Franco DP et al. J Bone Joint Surg Am 2009;91;1689–97.

This retrospective review was conducted to compare open reduction–internal fixation (ORIF) using angled locking plates with shoulder hemiarthroplasty for three- and four-part proximal humeral fractures. Patients treated with ORIF had better outcomes.

 

Proximal humeral fractures are common among the osteoporotic elderly population. Treatment options for three- or four-part comminuted fractures of the proximal humerus vary, with surgical choices ranging from simple percutaneous K wire fixation (which can have poor results) to endoprosthetic replacement of the humeral head. Within this spectrum, open reduction–internal fixation (ORIF) using angled locking plates is increasingly being used as an alternative to shoulder hemiarthroplasty because of its ability to maintain angular stability under physiological loads in osteoporotic bone with minimal biological disruption.

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