The outcome of surgical management of proximal humeral fractures using locking plates: comparison between locking plates with different geometry

Chen, Jiun-Liang; Chang, Fu-Chun; Lin, Shih-Jie; Chuang, Po-Yao; Peng, Kuo-Ti; Huang, Kuo‐Chin; Huang, Tsan-Wen

doi:10.1016/j.jse.2018.05.033

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…This mechanism is particularly advantageous in osteoporotic bone. The conical pattern of proximal screw distribution supports the articular surface: screws act as pillars for subchondral bone 46 . To obtain good results in plating, the first mandatory step is fracture reduction.…”

Section: Plate Fixationmentioning

confidence: 86%

Plate osteosynthesis of proximal humerus fractures: treatment options and technical advancements

et al. 2021

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Section: Plate Fixationmentioning

confidence: 86%

Plate osteosynthesis of proximal humerus fractures: treatment options and technical advancements

et al. 2021

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“…In our previous work [ 15 ], we confirmed that fractures with disrupted medial calcar support are associated with unfavorable clinical and radiographic outcomes. Additionally, we also identified that medial calcar disruption is a significant risk factor for predicting the osteonecrosis of humeral head and redisplacement of fracture reduction following ORIF [ 31 ]. To further verify the effect of medial support on plate fixation stability, we modified the method proposed by Carbone et al [ 19 ] to evaluate the extent of humeral head impaction in the status of osteoporosis combined with medial support deficiency.…”

Section: Discussionmentioning

confidence: 99%

The effect of medial calcar support on proximal humeral fractures treated with locking plates

et al. 2022

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Background Studies have reported mixed results on the importance of medial calcar support for the treatment of proximal humeral fractures. The purpose of this study was to compare radiographic and functional outcomes of patients who had displaced proximal humeral fractures with varying levels of medial support. Methods We performed a retrospective comparative cohort study. The study was conducted at a Level III trauma center in Taiwan. Seventy patients with proximal humeral fractures were collected retrospectively from 2015 to 2019. Only patients with two-, three-, or four-part types (Neer type I, II, or III) of displaced proximal humeral fractures were included in this study. However, patients with head-split fracture patterns, shoulder dislocation, prior shoulder trauma, and poor fracture reduction present in postoperative films were excluded. We assessed the radiographic outcomes, including the reduction score and amount of impaction in the humeral head. The functional outcome was evaluated based on the Constant score. Results Patients were grouped into the intact medial calcar group and the medial calcar deficiency group. In a subgroup analysis, the group with intact medial support had a significantly lower amount of impaction and a higher Constant score compared with the medial calcar deficiency group. Additionally, the groups with intact medial support had a nonsignificant difference in the Constant score between the affected side and the contralateral side. Conclusion The amount of impaction and the reduction score in the humeral head at the 12-month radiographic follow-up were significantly higher in the group with medial support deficiency. However, the reduction score after surgery exhibited no difference. This implies that the inherent nature of medial comminution of proximal humeral fracture may lead to inferior radiographic outcomes.

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“…We reanalyzed the included literature by excluding each piece one at a time, and after excluding Fraser's (21) literature, we discovered that the reoperation rate SUCRA values for LP were significantly higher than HA. This finding may be related to the fact that, despite being consistently categorized as locking plate internal fixation, the technique of the procedure and the plates have been evolving over time (32)(33)(34). This implies that the results of earlier human research need to be viewed with greater objectivity because improved surgical procedures and plates may have reduced the incidence of negative events like reoperation rates for LP-treated proximal humeral fractures.…”

Section: Discussionmentioning

confidence: 99%

Different treatments for 3- or 4-part proximal humeral fractures in the elderly patients: A Bayesian network meta-analysis of randomized controlled trials

Guo

Peng

et al. 2022

Front. Surg.

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BackgroundProximal humeral fractures are the third most common fracture in the body, and their incidence is rising year by year as the population ages. However, the treatment of the proximal humerus in parts 3 and 4 is still debatable, necessitating a network meta-analysis to determine the best treatment for each treatment modality.MethodsWe searched PubMed, Embase, Cochrane Library for randomized controlled trials on proximal humeral fractures up to June 21, 2022. We performed data extraction and literature quality assessment by two independent authors and extracted constant score and reoperation rate as indicators for evaluation. Stata software, Revman software, JAGS software and the R-based BlandAltmanLeh package, gemtc package and riags package were used to perform this Bayesian network meta-analysis.ResultsFollowing screening, 11 papers with a total of 648 participants were included in the analysis. The SUCRA values for the constant score were in the following order: RSA, IMN, Conservative, HA, and LP, and the SUCRA values for the reoperation rate were LP, HA, IMN, Conservative, and RSA.ConclusionThe elderly with 3- or 4-part proximal humeral fractures should consider RSA because it received the best evaluation ranking in terms of constant score and reoperation rate. Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341209, identifier: CRD42022341209.

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The outcome of surgical management of proximal humeral fractures using locking plates: comparison between locking plates with different geometry

Cited by 9 publications

References 29 publications

Plate osteosynthesis of proximal humerus fractures: treatment options and technical advancements

Plate osteosynthesis of proximal humerus fractures: treatment options and technical advancements

The effect of medial calcar support on proximal humeral fractures treated with locking plates

Different treatments for 3- or 4-part proximal humeral fractures in the elderly patients: A Bayesian network meta-analysis of randomized controlled trials

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