Objective: The purpose of this study was to determine the efficacy of proximal humerus locking plates (PHLP) and to clarify predictors of loss of fixation.
Design: Retrospective review of patients with proximal humerus fractures fixed with a PHLP.
Setting: Five Level 1 trauma centers.
Patients: One hundred fifty-three patients (111 female, 42 male) 18 years or older with a displaced fracture or fracture-dislocation of the proximal humerus treated with a PHLP between January 1, 2001 and July 31, 2005.
Intervention: Demographic data, trauma mechanism, surgical approach, and perioperative complications were collected from the medical records. Fracture classification according to the AO/OTA, radiographic head-shaft angle, and screw tip-articular surface distance in true anteroposterior (AP) and axillary lateral radiographs of the shoulder were measured postoperatively. Varus malreduction was defined as a head-shaft angle of <120 degrees.
Main Outcome Measurements: Statistical analysis was done to establish correlations between loss of fixation and postoperative head-shaft angle in the true AP radiograph, patient age, fracture type, trauma mechanism, number of locking head screws, and type of plate.
Results: The mean age was 62.3 +/- 15.4 years (22-92) and the mean injury severity score (ISS) was 9.5 +/- 10.16 (4-57; n = 73). The surgical approach was deltopectoral (90.2%) or transdeltoid (9.8%). No intraoperative complications were reported. The mean postoperative head-shaft angle was 130 degrees (95 degrees to 160 degrees; SD = 13). The overall incidence of loss of fixation was 13.7%. There was a statistically significant association between varus reduction (<120 degrees) and loss of fixation (30.4% when the head-shaft angle was <120 degrees versus 11% when the head-shaft angle was > or =120 degrees; P = 0.02).
Conclusion: This series presents the experience using PHLP in 5 Level 1 trauma centers. There were no intraoperative complications related to the locking plate systems. Despite the use of fixed-angle devices, loss of fixation occurred, primarily in the presence of varus malreduction. Our findings suggest that avoiding varus should substantially decrease the risk of postoperative failures.
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http://dx.doi.org/10.1097/BOT.0b013e31815bb09d | DOI Listing |
J Pediatr Orthop B
January 2025
Department of Orthopaedic Trauma Surgery, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong Province, China.
This study aimed to summarize the clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children. Data of 43 children with acute osteomyelitis of long bones diagnosed and treated from November 2017 to January 2021 were retrospectively analyzed. Medical records, laboratory results, and MRI were reviewed.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Purpose: If surgery is indicated for elderly patients suffering a proximal humerus fracture, reverse fracture arthroplasty became the preferred type of treatment due to its good and reliable outcomes over the last decade. Surgeons could choose from a wide range of implants and up to now there was no evaluation, if a change of the manufacturer affects patients` outcome.
Methods: The last 100 patients before and the first 100 after manufacturer change in reverse fracture arthroplasty were evaluated at a level one trauma center, all treated by only 3 senior shoulder surgeons.
Shoulder Elbow
January 2025
Department of Orthopaedic Surgery, Capio St Görans Hospital, Stockholm, Sweden.
Background: The aim of this study was to evaluate clinical results and complication rate in patients with proximal humeral fracture treated with Anatomical Locking Plate System (A.L.P.
View Article and Find Full Text PDFSkeletal Radiol
January 2025
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
Objective: This study is aimed at evaluating the distribution of metastatic bone disease (MBD), with a particular focus on the humerus, and its association with pathological fractures. Factors for contributing to the underestimation of fracture risk were assessed, including their impact on surgical management.
Materials And Methods: We retrospectively reviewed patient records of patients undergoing surgical treatment for MBD at our institution between 2005 and 2023.
Am J Biol Anthropol
January 2025
Laboratorio de Evolución Humana, Universidad de Burgos. Edificio I+D+i/CIBA, Burgos, Spain.
Objectives: The current research delves into the use of 3D geometric morphometric for assessing shifts in maturity within both the proximal and distal humeral metaphyses. It mainly focuses on establishing correlations between these shifts and the shape changes observed in the corresponding epiphyses established through radiographic imaging.
Material And Methods: The total sample comprises 120 right-side proximal humeral metaphyses and 91 right-side distal humeral metaphyses.
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