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Archives of Orthopaedic and Trauma Surgery

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01-12-2017 | Trauma Surgery

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

Authors: Frank J. P. Beeres, N. D. L. Hallensleben, S. J. Rhemrev, J. C. Goslings, F. Oehme, S. A. G. Meylaerts, R. Babst, N. W. L. Schep

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2017

Abstract

Objective

The primary aim was to evaluate the number of complications following locking plate fixation of proximal humeral fractures in country X and in country Y. The secondary aim was to identify risk factors for complications.

Methods

Multicentre retrospective case series of 282 consecutive patients with proximal humeral fractures, treated with a locking plate between 2010 and 2014. Setting: two level 1 trauma centres in country X and one in country Y. Data pertaining to demographics, postoperative complications and re-operations were collected. Fractures were classified according to the AO and Hertel classifications and experienced surgeons assessed the quality of reduction and plate fixation on the postoperative X-rays. Outcomes of the two different countries were compared and logistic regression analysis was performed to analyse the relationship between risk factors and complications.

Results

During a median follow-up of 370 days, 196 complications were encountered in 127 patients (45%). The most frequent complications were: screw perforation in the glenohumeral joint (23%), persistent shoulder complaints (16%), avascular necrosis of the humeral head (10%) and secondary fracture displacement (5%). In 80 patients (28%), 132 re-operations were performed. The patients operated in country X had significantly more complications compared with the patients operated in country Y. For implant-related complications, advanced age, non-anatomic reduction of the greater tuberosity, and country of operation were risk factors.

Conclusion

The use of locking plates for proximal humeral fractures was associated with a high number of complications in both countries; the patients operated in country Y, however, had better results compared with the patients operated in country X.

Level of evidence

IV.

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Title: Plate fixation of the proximal humerus: an international multicentre comparative study of postoperative complications
Authors: Frank J. P. Beeres
N. D. L. Hallensleben
S. J. Rhemrev
J. C. Goslings
F. Oehme
S. A. G. Meylaerts
R. Babst
N. W. L. Schep
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2790-z

At a glance: The STEP trials

Springer Medicine

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

Abstract

Objective

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Level of evidence

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