More Adverse Events after Osteosyntheses Compared to Arthroplasty in Geriatric Proximal Humeral Fractures Involving Anatomical Neck

Porschke, Felix; Bockmeyer, Julia; Nolte, Philip-Christian; Studier-Fischer, Stefan; Guehring, Thorsten; Schnetzke, Marc

doi:10.3390/jcm10050979

Cited by 10 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent systematic review on screw perforations after LPF failed to show sex differences due to missing information on sex [ 56 ]. To the knowledge of the authors, there is only one study by Porschke and colleagues that directly compares complications between LPF and RTSA in a geriatric population after PHF [ 57 ]. The authors analyzed 31 patients after LPF, 14 after RTSA and 14 after hemiarthroplasty with a mean follow up of 2.7 years, and found significantly more surgical complications and revision surgeries after LPF.…”

Section: Discussionmentioning

confidence: 99%

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Köppe

Katthagen

Rischen

et al. 2021

JCM

View full text Add to dashboard Cite

Aims: The best surgical treatment of multi-fragmentary proximal humeral fractures in the elderly is a highly controversial topic. The aim of this study is to assess for sex-related differences regarding mortality and complications after reverse total shoulder arthroplasty (RTSA) and locking plate fixation (LPF). Patients and Methods: All patients from the largest German healthcare insurance (26.5 million policy holders) above the age of 65 years that were treated with LPF or RTSA after a multi-fragmentary proximal humerus fracture between January 2010 and September 2018 were included. Multivariable Cox regression models were used to assess the association of sex with overall survival, major adverse events and surgical complications. Results: A total of 8264 (15%) men and 45,707 (85%) women were followed up for a median time of 52 months. After 8 years, male patients showed significantly higher rates for death (65.8%; 95% CI 63.9–67.5% vs. 51.1%; 95% CI 50.3–51.9%; p < 0.001) and major adverse events (75.5%; 95% CI 73.8–77.1% vs. 61.7%; 95% CI 60.9–62.5%; p < 0.001). With regard to surgical complications, after adjustment of patient risk profiles, there were no differences between females and males after LPF (p > 0.05), whereas men showed a significantly increased risk after RTSA (HR 1.86; 95% CI 1.56–2.22; p < 0.001) with more revision surgeries performed (HR 1.76, 95% CI 1.46–2.12; p < 0.001) compared to women. Conclusion: The male sex is an independent risk factor for death and major adverse events after both LPF and RTSA. An increased risk for surgical complications after RTSA suggests that male patients benefit more from LPF. Sex should be considered before making treatment decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Köppe

Katthagen

Rischen

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…While the general consensus for nondisplaced proximal humerus fractures is conservative treatment with a sling and early physiotherapy [ 3 ], the treatment of displaced and unstable fractures remains open to debate [ 1 ]. However, the most established surgical procedure is open reduction and internal fixation by angular stable plating, with a complication rate of up to 30% [ 4 , 5 , 6 , 7 , 8 ]. Schuetze et al recently published an overall complication rate of 21% in geriatric patients after minimally invasive locking plating [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures

Siebenbürger¹,

Neudeck²,

Daferner

et al. 2023

JCM

View full text Add to dashboard Cite

Introduction: The aim of this study was to create a novel complication classification for osteosynthesis-related complications following angular stable plating of the proximal humerus subsuming the influence of these complications on clinical outcome in relation to fracture morphology and consequent revision strategies. A total of 1047 proximal humerus fractures with overall 193 osteosynthesis-associated complications (24.5%) were included. The following complication types could be clarified: complication Type 1 is defined by mild varus (<20°) or valgus displacement of the humeral head without resulting in a screw cutout through the humeral head cortex. Type 2a is defined by varus displacement (<20°) of the humeral head associated with screw cutout through the humeral head cortex. Type 2b complication is limited to displacement of the greater tuberosity, lesser tuberosity, or both tuberosities. Complication Type 2c is defined by severe varus dislocation (>20°) of the humeral head with screw cutout at the humeral head cortex. Complication Type 3 describes a displacement of the angular stable plate in the humeral shaft region with associated shaft-sided screw cutout, while the position of the humeral head remains static. Complication Type 4 is characterized by the occurrence of AVN with or without glenoidal affection (4a/b). Clinical outcome according to the constant score was mainly affected by type 2–4, leading to a deteriorated result. Depending on the type of complication, specific revision strategies can be considered. Additionally, more complex fracture patterns fostered the incidence of complications.

show abstract

Augmentationstechniken zur Versorgung osteoporoseassoziierter Frakturen der Extremitäten

Pankratz,

Dehner,

Gebhard

et al. 2024

Unfallchirurgie

View full text Add to dashboard Cite

More Adverse Events after Osteosyntheses Compared to Arthroplasty in Geriatric Proximal Humeral Fractures Involving Anatomical Neck

Cited by 10 publications

References 38 publications

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures

Augmentationstechniken zur Versorgung osteoporoseassoziierter Frakturen der Extremitäten

Contact Info

Product

Resources

About