Plate fixation of the proximal humerus: an international multicentre comparative study of postoperative complications

Abstract

IV.

Cement augmentation of the proximal humerus internal locking system in elderly patients: a multicenter randomized controlled trial

“…In comparison to a previous study with a younger study population where anatomical reduction was achieved in 25.7% (9/35) of the patients and medial support achieved in 51.4% (18/35), the current study had a much higher rate of anatomical reduction (68.6% for the control group and 69% for the augmented group) and restoration of medial support (62.9% for the control group and 62.1% for the augmented group) [ 7 ]. This is consistent with the previous suggestion that the most important factor in determining good outcomes was good surgical techniques [ 7 , 11 , 14 , 17 , 49 ]. In addition, a Hawthorne effect cannot be ruled out: given the prospective study design, the surgeons may have paid more attention to surgical details contributing to the observed lower mechanical failure rate.…”

“…Although it is hard to compare the AE rate of different studies due to their heterogeneity (e.g., different reporting criterion, study design, patient population, and different surgical techniques), the currently reported AE rate of 41.7% in the control group and 41.5% in the augmented group are in the upper range of previous reports [ 5 , 9 , 10 , 14 , 20 , 22 , 49 ]. This could be due to the prospective nature of the study and a more comprehensive collection of AEs.…”

“…With the highest mean age (76.8 ± 6.8) recorded in the PHF surgery literature so far [ 15 , 27 ] and a very low BMD of 87.2 ± 20 [ 17 , 48 ], the current study nevertheless achieved an overall mechanical failure rate of around 15%. Although it is difficult to compare our mechanical failure rate with literature values due to the reporting heterogeneity, the current mechanical failure rate is likely to be on the lower end of what have been reported [ 4 , 14 , 20 , 23 , 27 , 49 ]. In osteoporotic fracture care, with the restoration of the medial hinge and intrinsic stability through anatomical reduction, implants become a load sharing rather than a load bearing construct leading to reduced mechanical failure rates.…”

Bilateral Proximal Humerus Fracture – a Rare Combination with a High Complication Rate after Surgery

“…Residual functional deficits after comminuted displaced fractures are common [9,10,16]. Furthermore, the risk of secondary complications, such as secondary loss of reduction, humeral head necrosis and screw perforation, increases with rising complexity of the fracture [5,11,16,17]. While proximal humerus fracture-related permanent functional deficits in a single arm are already difficult to cope with, persistent impaired mobility or discomfort in both arms can be debilitating for patients, both physically and mentally.…”

Valoración cuantitativa de la pérdida de funcionalidad asociada a la aparición de complicaciones en osteosíntesis de fracturas de húmero proximal

“…Como consecuencia, se han mejorado considerablemente los resultados funcionales en este tipo de pacientes. Por otro lado, se ha advertido un número importante de complicaciones relacionadas con la osteosíntesis de estas fracturas [5][6] , siendo las más frecuentes la protrusión de los tornillos, la necrosis avascular de la cabeza humeral o fracturas periimplante 7 . En la actualidad, existen pocos estudios que establezcan la relación entre la pérdida de funcionalidad y la aparición de estas complicaciones (8)(9) .…”