Displaced proximal humeral fractures. Seven years' experience with a modified Zickel supracondylar device.

A modified Zickel supracondylar rod was used in a prospective study for the fixation of 31 fractures of the proximal humerus in a patient population an average of 55 years of age. The follow-up period averaged 18 months and the overall Neer score at the time of final follow-up examination was 83. Six two-part fractures, ten three-part fractures and fracture dislocations, seven four-part fractures and dislocations, four pathologic fractures, and four humeral shaft fractures were treated with the device. The Neer score did not vary significantly among the groups, although the group with four-part fractures and dislocations was much younger than the overall group. Radiographic evidence of avascular necrosis occurred in the four-part group, but this was not associated with collapse or clinical findings. There was a slight correlation between increasing age and decreasing clinical result. There were no nonunions, vascular injuries, or infections in any patient.