Operative Treatment of Proximal Humeral Fracture using Inlay Graft of Fibular Allograft Combined with Plating

Cho, Duck Yun; Koh, Eun Sung; Lee, Myong Hyoung

Abstract

Fracture of the proximal humerus occurs more frequently in older individuals who may have advancing osteoporosis, causing the bone to weaken, even with minimal force. And, most proximal humeral fractures respond satisfactory to conservative treatment. But, operative treatment is reconmended in the case that poor results are anticipated by the severe displacement and comminution. In older patient with proximal humerus fracture, there was some problem such as osteoporosis, absorption of cancellous bone, cystic formation, and weakness of the mechanical support, and it has difficulties in rigid fixation and early ROM. Four cases of displaced fracture of the proximal humerus in older patients over 50-year-old Treated by using plate & inlay fibular allograft from Apr. 1991 to Dec. 1993 were analized clinically and radiologically. The following results were obtained. 1. The results of these patients were rated by the Neers functional criteria. Of four cases, three cases had excellent results, one case had satisfactory. 2. There was no allograft related complications, such as infection & graft rejection. So, in treatment of proximal humerus fracture at old individuals, open reduction and internal fixation with plating and inlay graft using fibular allograft was very useful method, and it resulted in rigid fixation, early ROM. and good functional result.