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Positive results possible with angular stable plate fixation of humeral fractures
Angular stable plate fixation of displaced proximal humeral fractures resulted in good medium- to long-term results, according to recently published study findings.
Researchers prospectively conducted a clinical and radiological evaluation of 77 patients with displaced proximal humeral fractures who underwent angular stable plate fixation. The mean follow-up period was 95.7 months.
The researchers evaluated the rotator cuffs of both shoulders using ultrasound, in addition to recording Constant, University of California – Los Angeles (UCLA) and DASH scores. Additionally, specific patient- and fracture-related parameters, including complications, were evaluated. Prognostic factors were split into three parameter groups: intrinsic parameters, injury-related parameters and therapy-related parameters.
Results showed mean Constant, UCLA and DASH scores were 79 points, 31 points and 12 points, respectively, at follow-up. Thirty-one patients were surgically retreated once or more than once due to minor or major complications. According to the researchers, revision surgeries included 13 implant-related impingements, 10 screw perforations, one secondary lesser tuberosity fracture dislocation and seven minor complications.
Anatomic reduction was observed in 40 cases after radiologic analysis. Residual bone deformity was not observed in 37 cases after the healing period. Ultrasound analysis showed unilateral defects of the rotator cuff on the fractured side in 11 cases and in two cases on the contralateral side.
At the concluding follow-up, a significant correlation between poorer score results and the occurrence of secondary fracture displacement, screw peroration, residual bone deformities and rotator cuff repairs was observed, according to the researchers.
The researchers concluded that the aim of the surgery should be reconstruction within a 15° range in anteroposterior and axillary views with a less than 5-mm tuberosity displacement. ‒ by Monica Jaramillo
Disclosures: Bahrs reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.