Retrospect?ve compar?son of cl?n?cal and rad?olog?cal results of conservat?ve and lock?ng anatom?cal plates for neer type 2 and type 3 prox?mal humerus fractures ?n pat?ents over 40 years of age

Abstract

Proximal humerus fractures are one of the most common fractures in adults. Its incidence is increasing day by day with the increase in life expectancy in society. It was aimed to compare the radiological and functional results of patients over the age of 40 who were treated with conservative and anatomical locking plate (Philos) in our clinic due to Neer type 2 and type 3 proximal fractures. 82 patients who came to Bursa Uludağ University Hospital Orthopedics and Traumatology Clinic and Polyclinic with the diagnosis of Neer type 2 and type 3 proximal humerus fractures between January 2010 and December 2020, whose treatment was planned and completed, and who came for periodic control after discharge, were included in the study. For this purpose, X-ray radiographs, surgery notes and electronic file records in the PACS system were used. The functional results of the patients were evaluated according to the physical examinations at their last follow-up and Constant, ASES and DASH shoulder scoring. There was no significant difference in functional and radiological results between patients treated with conservative treatment and plate. In the measurements made at the last follow-up, the average head-neck angle was 136.2 (115-165) in the conservative group and 134.4 (113-165) in the surgical group. According to the Constant-Murley scoring in the evaluation made at the last follow-up of the patients, the median value out of a total of 100 points was 65.9 (10-98) in the conservative group and 73.9 (35-98) in the surgical group. ASES score is calculated out of a total of 100 points. The median value was 63.3(5-100) in the conservative group and 68.3(23.3-95) in the surgical group. DASH score is calculated from 0 at best to 100 at worst. The median value was 33.3(0-97.5) in the conservative group and 25(4.2-71.7) in the surgical group. In proximal humerus fractures, the fracture type and morphology should first be well defined and classified. When planning the treatment of patients, decisions should not only be made based on the type of fracture, but the treatment plan should also be taken into account by taking into account the patient's functional expectations and comorbidities.