Analysis of the functional results of internal osteosynthesis in fractures of the proximal humerus

Between 1998 and 2002,32 patients (11 males,21 females), aged 26-78 years, with proximal humerus fractures were operated on. In 29 cases osseous osteosynthesis by AO technique with T- and L-shape plates and screws was performed, in 2 cases osteosynthesis was carried out using Kirshner wire and in 1 case with screws and wire. In all patients functional results were evaluated by American Shoulder and Elbow Surgeons system in terms from 7 to 48 months after operation. The following parameters were included: pain, movement range, muscular force, stability/instability of shoulder joint, limb function. In patients over 60 years movement range and limb function were reliably decreased compared to younger patients (p<0.05). Elderly age, osteopenia, complex nature of fractures negatively influenced the osteosynthesis outcomes. Tactics of surgical intervention in elderly patients should be based on the application of more sparing and stiff fixation.