This article is more than 5 years old. Information may no longer be current.
Bone density not linked to mechanical failure of fracture fixation
Researchers were unable to find a link between bone mineral density and mechanical failure rates following proximal humeral fracture fixation, indicating that patients with normal bone mineral density may be less prone to proximal humeral fractures.
In a 1-year, prospective, multicenter cohort study, researchers analyzed 150 patients with locking plate fixation of a closed, displaced proximal humeral fracture. Preoperative humeral bone mineral density was determined via computed tomography (CT) scans, and dual X-ray absorptiometry of the distal radial end of the healthy arm was taken within 6 weeks postoperatively.
Standard radiographs were made at postoperative follow-up points of 6 weeks, 3 months and 1 year. Pain, shoulder mobility, strength, and multiple functional and quality-of-life outcome measures were also evaluated at this time.
Overall, 53 patients (35%) had observable mechanical failure, which was defined at showing evidence of bone quality complications within 1 year postoperatively. Patients with and without such failure had no significant difference in CT measures of area bone mineral density (89.82 mg/cm3 vs. 91.51 mg/cm3, respectively). Loss of reduction and secondary screw loosening with perforation was frequently observed in this cohort.
All pain, shoulder mobility, strength, and multiple functional and quality-of-life outcome measures were found to be significantly better among patients who did not experience mechanical failures, according to the researchers.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.