Le traitement chirurgical des fractures de la palette humérale chez l’adulte

The treatment of humeral pallet fractures is mainly based on reconstruction surgery with osteosynthesis. We collected the data of 40 patients with humeral pallet fracture from our archives in the Department of Orthopaedics and Traumatology at the Ibn Sina University Hospital, Rabat from january 2012 to december 2014. The aim of our study was to highlight the clinical, therapeutic and evolutionary features of these fractures as well as the challenges in managing these complex fractures and in evaluating the results. There was a clear male predominance (75% of cases) with an average age of 35 years. Etiologies were dominated by road accidents (56%). All our patients had an emergency hospital admissions and underwent surgery. Type C fracture, according to MÜLLER and ALLGOWER (A.O) classification was the most frequent: 62.5% of cases. Associated lesions were fairly frequent (52.5%) in polytraumas. All our patients underwent surgery (100% of cases), via posterior border in 70% of cases. This procedure included reduction and then osteosynthesis using a Lecestre-type plate in 82.5% of the cases. Our results were good and average in 85.5% of cases, according to literature data. The management of this type of fracture is based on perfect anatomic reduction, a solid assembly which should allow an early reeducation resulting in good functional result.