Treatment of Acute Proximal Humerus Fractures with an Evans Staple


The purpose of this study was to report on radiographic, objective, and functional outcomes in patients with 2- and 3-part proximal humerus fractures treated with an Evans staple. Six patients (three males and three females) who had had acute, displaced proximal humerus fractures requiring operative treatment were identified and their medical records reviewed. There were four 2-part and two 3-part fractures as described by Neer. Mean age was 68.5 (range, 57 to 73) years; mean followup was 71.1 (range, 30 to 98) months. The senior author (T.W.W.) was the treating physician who determined the treatment method. All patients were treated within 2 weeks of injury using an Evans staple (Smith & Nephew, Memphis, TN), with or without tension band. Clinical outcome measurements were fracture healing, range of motion, complications, Shoulder Pain and Disability Index (SPADI) score, and radiologic outcome. All six fractures reached clinical and radiographic union at a mean of 4.2 months without postoperative complications. Two patients required subsequent hardware removal. Mean SPADI score at last followup was 36.8 (good). Average radiologic neck/shaft angle was 110 (range, 92 to 136) degrees. The Evans staple is a valuable implant for treatment of 2- and 3-part proximal humerus fractures requiring a relatively simple surgical implantation and minimal soft tissue dissection. (Journal of Surgical Orthopaedic Advances 20(3):176–181, 2011)

Christopher R. Sforzo, MD, Jason J. Marshall, MD, and Thomas W. Wright, MD