Jan Dauwe1, Gregory Walters2, Eduard Van Eecke3, Kris Vanhaecht4, Stefaan Nijs2. 1. Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium. dauwejan@gmail.com. 2. Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium. 3. Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium. 4. Leuven Institute for Healthcare Policy, Catholic University of Leuven, Leuven, Belgium.
Abstract
PURPOSE: Proximal humeral fractures are the third most common fractures affecting the elderly. Angular stable osteosynthesis has become indispensable in the operative treatment. However, surgical fixation remains challenging. The aim of this retrospective study was to analyse the failure rate after osteosynthesis of proximal humeral fractures over a year in a level-1 trauma centre. Furthermore, parameters that are presumed to be related to osteosynthesis failure will be investigated and discussed. METHODS: After meeting the exclusion criteria, 134 patients were operatively treated with angular stable osteosynthesis between January 2017 and January 2018 at the University Hospitals of Leuven. RESULTS: Circa 16% of the proximal humeral osteosyntheses failed. Our study showed that the most significant parameter for osteosynthesis failure was smoking. The odds of failure were significantly lower if treated by a shoulder surgeon compared to another trauma surgeon in the plate and nail group combined. CONCLUSION: The management of proximal humeral fracture osteosynthesis remains a controversial subject. In this retrospective analysis, a failure rate of 15.7% was calculated. Smoking is a statistically significant parameter related to osteosynthesis failure. The subspecialty of the treating trauma surgeon affected the failure rate significantly. A lower failure rate was noted after osteosynthesis by a shoulder surgeon compared to another trauma surgeon.
PURPOSE: Proximal humeral fractures are the third most common fractures affecting the elderly. Angular stable osteosynthesis has become indispensable in the operative treatment. However, surgical fixation remains challenging. The aim of this retrospective study was to analyse the failure rate after osteosynthesis of proximal humeral fractures over a year in a level-1 trauma centre. Furthermore, parameters that are presumed to be related to osteosynthesis failure will be investigated and discussed. METHODS: After meeting the exclusion criteria, 134 patients were operatively treated with angular stable osteosynthesis between January 2017 and January 2018 at the University Hospitals of Leuven. RESULTS: Circa 16% of the proximal humeral osteosyntheses failed. Our study showed that the most significant parameter for osteosynthesis failure was smoking. The odds of failure were significantly lower if treated by a shoulder surgeon compared to another trauma surgeon in the plate and nail group combined. CONCLUSION: The management of proximal humeral fracture osteosynthesis remains a controversial subject. In this retrospective analysis, a failure rate of 15.7% was calculated. Smoking is a statistically significant parameter related to osteosynthesis failure. The subspecialty of the treating trauma surgeon affected the failure rate significantly. A lower failure rate was noted after osteosynthesis by a shoulder surgeon compared to another trauma surgeon.
Authors: Klaus J Burkhart; Sven O Dietz; Leonard Bastian; Ulrich Thelen; Reinhard Hoffmann; Lars P Müller Journal: Dtsch Arztebl Int Date: 2013-09-02 Impact factor: 5.594
Authors: Rony-Orijit Dey Hazra; Johanna Illner; Karol Szewczyk; Mara Warnhoff; Alexander Ellwein; Robert Maximillian Blach; Helmut Lill; Gunnar Jensen Journal: J Clin Med Date: 2022-01-14 Impact factor: 4.241