Quantitative assessment of the loss of functionality associated with the appearance of complications in osteosynthesis of proximal humerus fractures
DOI:
https://doi.org/10.31053/1853.0605.v76.n1.21630Keywords:
humeral fractures, osteoporotic fractures, fracture fixation internal, postoperative complications, treatment outcome, spatio-temporal analysisAbstract
OBJECTIVE: To evaluate the relationship between incidence of complications and clinico-functional outcomes, after fractures of the proximal humerus treated with locking plates.
MATERIAL AND METHODS: Our study reviewed 47 patients who underwent internal fixation with plate for a period of 5 years. We present the clinico-functional outcomes with Constant-Murley and Quick-Dash scores, and cinematic analysis. Statistical analysis of the relationship complication-functional results and new surgery-functional results.
RESULTS: At the end of the follow-up period, a total of 47 patients were recollected and the mean age was 74,85 years. 11 patients (23,4%) had complications, of whom 6 patients (12,7%) needed a new surgery. The complication rate is associated with loss of 65,41º of flexion, 14,49º of extension, 36,71º of abduction, 8,84º of aduction, 5,47º of external rotation and 30,82º of internal rotation. Furthermore, we found statistically significant differences between the incidence of complications and Constant-Murley and Quick Dash scores.
CONCLUSION: There is a high percentage of patients who developes complications after ORIF with and its functionality is significantly reduced. Our study accurately quantifies this loss and, in this way, it predicts the functional situation, according to the possible complicactions that may arise.Downloads
References
Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures. Bone. 1996 Mar 18(3 Suppl):209S-213S.
Zyto K, Ahrengart L, Sperber A, Törnkvist H. Treatment of displaced proximal humeral fractures in elderly patients. J Bone Joint Surg Br. 1997;79:412–7.
Siffri PC, Peindl RD, Coley ER, Norton J, Connor PM, Kellam JF. Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri. J Orthop Trauma. 2006 Sep;20(8):547–54.
Boesmueller S, Wech M, Gregori M, Domaszewski F, Bukaty A, Fialka C, Albrecht C. Risk factors for humeral head necrosis and non-union after plating in proximal humeral fractures. Injury. 2016 Feb;47(2):350-5.
Clavert P, Adam P, Bevort A, Bonnomet F, Kempf JF. Pitfalls and complications with locking plate for proximal humerus fracture. J Shoulder Elbow Surg. 2010 Jun;19(4):489–94.
Beeres FJP, Hallensleben NDL, Rhemrev SJ, Goslings JC, Oehme F, Meylaerts SAG, et al. Plate fixation of the proximal humerus: an international multicentre comparative study of postoperative complications. Arch Orthop Trauma Surg. 2017 Dec;137(12):1685-1692.
Björkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand. 2004 Dec;75(6):741–5.
Owsley KC, Gorczyca JT. Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fractures [corrected]. J Bone Joint Surg Am. 2008 Feb;90(2):233-40.
Ye T, Wang L, Zhuang C, Wang Y, Zhang W, Qiu S. Functional outcomes following locking plate fixation of complex proximal humeral fractures. Orthopedics. 2013 Jun;36(6):e715-22.
Levy O, Haddo O, Massoud S, Mullett H, Atoun E. A patient-derived Constant-Murley score is comparable to a clinician-derived score. Clin Orthop Relat Res. 2014 Jan;472(1):294-303.
Wylie JD, Beckmann JT, Granger E, Tashjian RZ. Functional outcomes assessment in shoulder surgery. World J Orthop. 2014 Nov 18;5(5):623-33.
Martinez AA, Cuenca J, Herrera A. Philos plate fixation for proximal humeral fractures. J Orthop Surg (Hong Kong). 2009 Apr;17(1):10-4.
Duralde XA, Leddy LR. The results of ORIF of displaced unstable proximal humeral fractures using a locking plate. J Shoulder Elbow Surg. 2010 Jun;19(4):480-8.
Parnes N, Jupiter JB. Fixed-angle locking plating of displaced proximal humerus fractures. Instr Course Lect. 2010;59:539-52.
Ong CC, Kwon YW, Walsh M, Davidovitch R, Zuckerman JD, Egol KA. Outcomes of open reduction and internal fixation of proximal humerus fractures managed with locking plates. Am J Orthop (Belle Mead NJ). 2012 Sep;41(9):407-12.
Erasmo R, Guerra G, Guerra L. Fractures and fracture-dislocations of the proximal humerus: A retrospective analysis of 82cases treated with the Philos(®) locking plate. Injury. 2014 Dec;45 Suppl 6:S43-8.
Norouzi M, Naderi MN, Komasi MH, Sharifzadeh SR, Shahrezaei M, Eajazi A. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures. Am J Orthop (Belle Mead NJ). 2012 May;41(5):E64-8.
Jost B, Spross C, Grehn H, Gerber C. Locking plate fixation of fractures of the proximal humerus: analysis of complications, revision strategies and outcome. J Shoulder Elbow Surg. 2013 Apr;22(4):542-9.
Jung SW, Shim SB, Kim HM, Lee JH, Lim HS. Factors that Influence Reduction Loss in Proximal Humerus Fracture Surgery. J Orthop Trauma. 2015 Jun;29(6):276-82.
Konrad G, Bayer J, Hepp P, Voigt C, Oestern H, Kääb M, et al. Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Surgical technique. J Bone Joint Surg Am. 2010 Mar;92 Suppl 1 Pt 1:85-95.
Spross C, Platz A, Rufibach K, Lattmann T, Forberger J, Dietrich M. The PHILOS plate for proximal humeral fractures--risk factors for complications at one year. J Trauma Acute Care Surg. 2012 Mar;72(3):783-92.
Schliemann B, Siemoneit J, Theisen Ch, Kösters C, Weimann A, Raschke MJ. Complex fractures of the proximal humerus in the elderly-outcome and complications afterlocking plate fixation. Musculoskelet Surg. 2012 May;96 Suppl 1:S3-11.
Boesmueller S, Wech M, Gregori M, Domaszewski F, Bukaty A, Fialka C, et al. Risk factors for humeral head necrosis and non-union after plating in proximal humeral fractures. Injury. 2016 Feb;47(2):350-5.
Patel S, Colaco HB, Elvey ME, Lee MH. Post-traumatic osteonecrosis of the proximal humerus. Injury.2015 Oct;46(10):1878-84.
Acklin YP, Stoffel K, Sommer C. A prospective analysis of the functional and radiological outcomes of minimally invasive plating in proximal humerus fractures. Injury. 2013 Apr;44(4):456-60.
Geiger EV, Maier M, Kelm A, Wutzler S, Seebach C, Marzi I. Functional outcome and complications following PHILOS plate fixation in proximal humeral fractures. Acta Orthop Traumatol Turc. 2010;44(1):1-6.
Published
How to Cite
Issue
Section
License
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
