Ben Ockert1, Georg Siebenbürger2, Mark Kettler3, Volker Braunstein4, Wolf Mutschler2. 1. Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany. Electronic address: Ben.Ockert@med.uni-muenchen.de. 2. Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany. 3. Red Cross Hospital, Munich, Germany. 4. Department of Trauma and Orthopaedic Surgery, Ludwig-Maximilians-University, Munich, Germany; Sportsclinic Germany, Munich, Germany.
Abstract
BACKGROUND: Locked plating has become an accepted treatment for displaced fractures of the proximal humerus. However, to our knowledge, long-term outcomes have not been reported. METHODS: Between February 2002 and March 2004, 121 patients with displaced proximal humeral fractures were treated by open reduction and locking plate fixation. Forty-three patients were available for 10-year (95% confidence interval [CI], 9.8-10.1) follow-up, including Constant score (CS), Disabilities of the Arm, Shoulder and Hand score, and Short Form 36 questionnaire. RESULTS: Of 43 patients (72% women; mean age at time of fracture repair, 58.2 years; 95% CI, 54.2-62.2), the absolute CS 10 years after surgery was 75.3 (95% CI, 69.2-81.4). The normalized CS was 88.4 (95% CI, 81.7-95.1), and the CS in percentage to the contralateral side (%CS) was 83.7 (95% CI, 78.5-88.9). In contrast, at 1 year, the CS was 73.9 (95% CI, 67.8-80.2, P = .774), the normalized CS was 87.2 (95% CI, 80.4-94.0; P = .765), and the %CS was 78.7 (95% CI, 71.5-85.8; P = .355). The CS at 10 years correlated with the CS at 1 year after surgery (r = 0.460; P < .01) and with patient gender (r = -0.424; P < .01), and it strongly correlated with patient age (r = -0.545; P < .001). CONCLUSIONS: Ten years after locked plating of displaced proximal humeral fractures, patients show good to excellent outcomes in the majority of cases with no relevant decline compared with the shoulder function 1 year after surgery. However, poor long-term outcome is seen in 16% of patients and relates to a low CS 1 year after surgery. Thus, patients developing poor long-term outcomes may be identified at an earlier stage.
BACKGROUND: Locked plating has become an accepted treatment for displaced fractures of the proximal humerus. However, to our knowledge, long-term outcomes have not been reported. METHODS: Between February 2002 and March 2004, 121 patients with displaced proximal humeral fractures were treated by open reduction and locking plate fixation. Forty-three patients were available for 10-year (95% confidence interval [CI], 9.8-10.1) follow-up, including Constant score (CS), Disabilities of the Arm, Shoulder and Hand score, and Short Form 36 questionnaire. RESULTS: Of 43 patients (72% women; mean age at time of fracture repair, 58.2 years; 95% CI, 54.2-62.2), the absolute CS 10 years after surgery was 75.3 (95% CI, 69.2-81.4). The normalized CS was 88.4 (95% CI, 81.7-95.1), and the CS in percentage to the contralateral side (%CS) was 83.7 (95% CI, 78.5-88.9). In contrast, at 1 year, the CS was 73.9 (95% CI, 67.8-80.2, P = .774), the normalized CS was 87.2 (95% CI, 80.4-94.0; P = .765), and the %CS was 78.7 (95% CI, 71.5-85.8; P = .355). The CS at 10 years correlated with the CS at 1 year after surgery (r = 0.460; P < .01) and with patient gender (r = -0.424; P < .01), and it strongly correlated with patient age (r = -0.545; P < .001). CONCLUSIONS: Ten years after locked plating of displaced proximal humeral fractures, patients show good to excellent outcomes in the majority of cases with no relevant decline compared with the shoulder function 1 year after surgery. However, poor long-term outcome is seen in 16% of patients and relates to a low CS 1 year after surgery. Thus, patients developing poor long-term outcomes may be identified at an earlier stage.
Authors: Jan Theopold; Bastian Marquaß; Johannes Fakler; Hanno Steinke; Christoph Josten; Pierre Hepp Journal: BMC Surg Date: 2016-03-12 Impact factor: 2.102
Authors: David Cruickshank; Kelly A Lefaivre; Herman Johal; Norma J MacIntyre; Sheila A Sprague; Taryn Scott; Pierre Guy; Peter A Cripton; Michael McKee; Mohit Bhandari; Gerard P Slobogean Journal: BMC Musculoskelet Disord Date: 2015-07-30 Impact factor: 2.362