Medial support is the critical risk factor for preventing failure after plating of proximal humerus fractures

Medial support is the critical risk factor for preventing failure after plating of proximal humerus fractures

The purpose of this study was to evaluate the risk factors of failure of fixation after locked plating of proximal humerus fractures. The study included displaced 71 proximal humerus fracture operation cases at a single centre between January 2016 and June 2020. All humeral fixation surgeries were performed with a proximal humerus locked plate. The primary outcome measure was failure of fixation. Age, gender, mechanism of injury, operated side, type of fracture, type of anesthesia, ASA score, surgical approach, presence of medial cortical support, neck-shaft angle, medial metaphyseal extension of fracture, medial hinge displacement, number of humeral head screws, number of calcar screws were the assessed variables. Newly proposed risk factors including lateral humeral offset (LHO), lateral glenohumeral offset (LGHO), humeral head diameter (HHD), LGHO/HHD ratio were also assessed radiologically. This study showed that lack of medial support was the only significant factor for the failure of proximal humerus fracture osteosynthesis (p

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  • 1. Röderer G, Erhardt J, Graf M, et al. Clinical results for minimally invasive locked plating of proximal humerus fractures. J Orthop Trauma. 2010;24:400-6.
  • 2. Fjalestad T, Strømsøe K, Blücher J, et al. Fractures in the proximal humerus: functional outcome and evaluation of 70 patients treated in hospital. Arch Orthop Trauma Surg. 2005;125:310-6.
  • 3. Gardner MJ. Hybrid Locked plating of osteoporotic fractures of the humerus. J Bone Jt Surg. 2006;88:1962-7.
  • 4. Fankhauser F, Boldin C, Schippinger G, et al. A New Locking Plate for Unstable Fractures of the Proximal Humerus. Clin Orthop Relat Res. 2005;430:176-81.
  • 5. Koukakis A, Apostolou CD, Taneja T, et al. Fixation of proximal humerus fractures using the PHILOS plate: Early experience. Clin Orthop Relat Res. 2006;442:115-20.
  • 6. Thanasas C, Kontakis G, Angoules A, et al. Treatment of proximal humerus fractures with locking plates: A systematic review. J Shoulder Elb Surg. 2009;18:837-44.
  • 7. Krappinger D, Bizzotto N, Riedmann S, et al. Predicting failure after surgical fixation of proximal humerus fractures. Injury. 2011;42:1283-8.
  • 8. Hardeman F, Bollars P, Donnelly M, et al. Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus. Injury. 2012;43:153-8.
  • 9. Neer CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970;52:1077-89.
  • 10. Gardner MJ, Weil Y, Barker JU, et al. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21:185-91.
  • 11. Takase K, Yamamoto K, Imakiire A, et al. The radiographic study in the relationship of the glenohumeral joint. J Orthop Res. 2004;22:298-305.
  • 12. Lescheid J, Zdero R, Shah S, et al. The biomechanics of locked plating for repairing proximal humerus fractures with or without medial cortical support. J Trauma Inj Infect Crit Care. 2010;69:1235-42.
  • 13. Jung SW, Shim SB, Kim HM, et al. Factors that influence reduction loss in proximal humerus fracture surgery. J Orthop Trauma. 2015;29:276-82.
  • 14. Hertel R, Hempfing A, Stiehler M, et al. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elb Surg. 2004;13:427-33.
  • 15. Sirisreetreerux N, Pengrung N, Apivatthakakul T. Proximal humerus exposure with the inverted-L anterolateral deltoid flip approach, anterolateral deltoid splitting approach, and deltopectoral approach: A comparative cadaveric study [published online ahead of print, 2020 Nov 9]. Injury. 2020;S0020-1383:30947-5.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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