Complications of Locked Plating for Proximal Humeral Fractures in Active Patients in a Level One Trauma Center

Abstract

Background The incidence of complications associated with locked plating of proximal humerus fractures (PHF) has been reported in up to 40% of surgeries. This study aimed to analyze the incidence and risk factors of complications and re-intervention associated with locked plating of PHF in a an young active working population. Methods This retrospective cohort study included patients indicated for locked plating of displaced PHF at a dedicated workers’ accident trauma center. The variables analyzed were patient comorbidities, fracture characteristics, and immediate radiologic surgical outcomes. Postoperative complications and risk factors were determined. Results A total of 127 patients with a median follow-up of 31 months and a median age of 52 years were included. The complication and reintervention rates were 13.4% and 12.6%, respectively. The main cause of reintervention was post-traumatic stiffness. The incidence of other complications was 4% screw protrusion, 1.6% avascular necrosis, 1.6% varus collapse. Complications were not associated with age, comorbidity, fracture classification, bone mineral density, Hertel's risk factors, presence of calcar comminution, reduction quality, and calcar screw position. Discussion The incidence of complications and reintervention was low. The main cause of reintervention was persistent stiffness, and no risk factors for complications were found in this study.

Age-Related changes in the morphological features of medial column of the proximal humerus in the Chinese population

“…These age-related changes in MC may be responsible for the increased risk of proximal humeral fractures (PHFs) and higher fracture severity (1,4,6,7). Furthermore, incompetent MC, i.e., fragile with impaired strength, due to advanced age is also associated with a higher risk of fracture complications (8)(9)(10)(11)(12). Conversely, elderly patients with severe osteopenia treated with integrity restoration of MC could achieve a satisfactory prognosis, similar to that of younger patients (13-16).…”