Clinical observation of patients with fractures of the proximal humerus bone in Kazakhstan

Background: Treatment of patients with fractures of the proximal humerus remains an urgent problem of modern traumatology and orthopedics. The aim of this work was to study the results of surgical treatment of patients with proximal humerus fractures in which plates with angular stability of screws were used for osteosynthesis.Materials and methods: Thirty six patients aged 18 to 75 years with fractures of the proximal humerus, ,were observed after treated in the polytrauma department of the City Clinical Hospital No. 4 in Almaty, Kazakhstan during the period from August 2019 to December 2021. There were12 men (33.4%) and 24 women (66.6%). According to the C.S., Neer patients were distributed as follows: two-part patients - 17 (47.2%), three-part patients - 11 (30.6%), four-partpatients-5(13.9%), fracture-dislocations of the humerus head-3 (8.3% ). Most of the patients applied before 3 days after injury (53.0%).Results: Positive treatment results were achieved in most cases with two and three fragmentary fractures and in those operated early (from 3 to 7 days) after injury. Plates with angular stability of the screws provided excellent and good treatment results in 69.5%, and a satisfactory result in 16.7%. The unsatisfactory results of treatment were 13.8%, and the incidence of postoperative complications was 19.4%.Conclusions: Performing stable osteosynthesis in three- to four-fragment fractures and fracture-dislocations of the humerus head is technically a difficult operation. A study of our material and literature has shown that the incidence of complications after extra-cortical osteosynthesis of the humerus is associated not only with the surgical technique of implant placement, but also with the nature of the damage, including osteoporosis, osteonecrosis, and pathology of bone tissue regeneration.