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Locking plate fixation with, without augmented screw tips yielded similar outcomes
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Patients with proximal humeral fractures who underwent locking plate fixation with augmentation of screw tips experienced clinical and radiographic outcomes similar to patients who underwent standard locking plate fixation only, according to published results.
Researchers assessed the Constant score, range of motion and the DASH score among 94 patients older than 65 years with displaced proximal humeral fractures who underwent fixation either with locking plate only (n=55; Philos, DePuy Synthes) or using a locking plate with fluoroscopy-controlled polymethyl methacrylate augmentations of screw tips (n=39). Researchers performed clinical and radiographic examinations of the affected shoulder after 6 weeks, at 3, 6 and 12 months and at 2-year postoperative follow-up.
Results showed a mean Constant score of approximately 62.6 points and 63.7 points in the locking plate only group and the locking plate with polymethyl methacrylate augmentations of screw tips group, respectively. Researchers found the locking plate only group had a mean Constant score as a percentage of the uninjured side of approximately 78.2% and a mean age- and sex-adjusted Constant score of approximately 72.4 points. The locking plate with polymethyl methacrylate augmentations of screw tips group had a mean Constant score as a percentage of the uninjured side of approximately 79.5% and a mean age- and sex-adjusted Constant score of approximately 76.8 points, according to results.
Researchers noted the locking plate only group had a mean DASH score of approximately 26.4 vs. 23.6 in the group with screw tip-augmented locking plate osteosynthesis. The locking plate only group had an overall complication rate of 16.3% and loss of fixation occurred in 10.9% of patients, according to results. This was compared with an overall complication rate of 12.8% and occurrence of loss of fixation of 5.1% in the group with screw tip-augmented osteosynthesis, results showed.
“Partial avascular necrosis around augmented screw tips needs further critical evaluation in studies with longer follow-up periods and larger numbers of cases,” the authors wrote. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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