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Open Access 01-12-2008 | Research article

Outcome analysis following removal of locking plate fixation of the proximal humerus

Authors: Chlodwig Kirchhoff, Volker Braunstein, Sonja Kirchhoff, Christoph M Sprecher, Ben Ockert, Florian Fischer, Bernd A Leidel, Peter Biberthaler

Published in: BMC Musculoskeletal Disorders | Issue 1/2008

Abstract

Background

Concerning surgical management experience with locking plates for proximal humeral fractures has been described with promising results. Though, distinct hardware related complaints after fracture union are reported. Information concerning the outcome after removal of hardware from the proximal humerus is lacking and most studies on hardware removal are focused on the lower extremity. Therefore the aim of this study was to analyze the functional short-term outcome following removal of locking plate fixation of the proximal humerus.

Methods

Patients undergoing removal of a locking plate of the proximal humerus were prospectively followed. Patients were subdivided into the following groups: Group HI: symptoms of hardware related subacromial impingement, Group RD: persisting rotation deficit, Group RQ: patients with request for a hardware removal. The clinical (Constant-Murley score) and radiologic (AP and axial view) follow-up took place three and six months after the operation. To evaluate subjective results, the Medical Outcomes Study Short Form-36 (SF-36), was completed.

Results

59 patients were included. The mean length of time with the hardware in place was 15.2 ± 3.81 months. The mean of the adjusted overall Constant score before hardware removal was 66.2 ± 25.2% and increased significantly to 73.1 ± 22.5% after 3 months; and to 84.3 ± 20.6% after 6 months (p < 0.001). The mean of preoperative pain on the VAS-scale before hardware removal was 5.2 ± 2.9, after 6 months pain in all groups decreased significantly (p < 0.001). The SF-36 physical component score revealed a significant overall improvement in both genders (p < 0.001) at six months.

Conclusion

A significant improvement of clinical outcome following removal was found. However, a general recommendation for hardware removal is not justified, as the risk of an anew surgical and anesthetic procedure with all possible complications has to be carefully taken into account. However, for patients with distinct symptoms it might be justified.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/9/138/prepub

Title: Outcome analysis following removal of locking plate fixation of the proximal humerus
Authors: Chlodwig Kirchhoff
Volker Braunstein
Sonja Kirchhoff
Christoph M Sprecher
Ben Ockert
Florian Fischer
Bernd A Leidel
Peter Biberthaler
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2008
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-9-138

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Outcome analysis following removal of locking plate fixation of the proximal humerus

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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