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Certain risk factors influential in reduction loss after proximal humerus fracture surgery
Through the use of multivariable regression analysis, researchers found the independent factors for reduction loss after proximal humerus fracture surgery were osteoporosis, displaced varus fracture, medial comminution and insufficient medial support.
The researchers retrospectively evaluated 252 patients (average age: 62.1 years) who underwent surgery for proximal humeral fractures with locking plates. The patients were divided into two groups: 17 patients were a part of the reduction loss group, and 235 patients were a part of the reduction maintenance group.
At the 12-month follow-up, all of the patients were examined and interviewed. Patient charts were reviewed for age, sex, comorbidities, bone mineral density (BMD) and surgical approach. Using X-rays, two independent examiners evaluated initial neck-shaft-angle (NSA), medial side comminution, Neer and Orthopaedic Trauma Association (AO OTA) classification, postoperative NSA and medial support presence. After univariable logistic regression analysis, any statistically significant factors were assessed with multivariable regression analysis.
Results showed the reduction loss rate overall was 6.7%. Revision surgery was performed in all patients in the reduction loss group. Compared with the reduction maintenance group, patients in the reduction loss group were not different with regard to gender, hypertension, diabetes, injury mechanism, Neer and AO OTA fracture types or deltopectoral approach, according to researchers. However, patients were significantly older in the reduction loss group.
In the reduction loss group, the medial comminution rate was more common compared with the reduction maintenance group. Additionally, postoperative NSA was significantly lower in the reduction loss group compared with the reduction maintenance group.
Univariable regression analysis results showed age, varus displacement, medial comminution, reduction adequacy and insufficient medial support were significantly associated with reduction loss, according to the researchers. However, further investigation through multivariable regression analysis showed osteoporosis, medial comminution, displaced varus and insufficient medial support were all independent risk factors of reduction loss. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.