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Mid-term results of a less-invasive locking plate fixation method for proximal humeral fractures: a prospective observational study.

Bockmann B, Buecking B, Franz D, Zettl R, Ruchholtz S, Mohr J - BMC Musculoskelet Disord (2015)

Bottom Line: The Constant score improved significantly (4.5 years: 70 ± 21, p < 0.001) between the first two follow-ups (6 weeks: 35 ± 14, 6 months: 56 ± 18, p < 0.001), and also between 6 months and 4.5 years post-surgery.At the final follow-up, the activities of daily living score had not reached pre-fracture levels (before trauma: 27 ± 5, 4.5 years: 20 ± 8, p < 0.001).The majority of our patients did not become pain-free or reach pre-fracture activity levels.

View Article: PubMed Central - PubMed

Affiliation: Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstrasse, 35043, Marburg, Germany. bockmann@med.uni-marburg.de.

ABSTRACT

Background: The optimal treatment for proximal humeral fractures remains under debate. In this article, we report the mid-term results of patients who underwent the less-invasive implantation of a polyaxial locking plate for displaced proximal humeral fractures.

Methods: This study included patients who were treated with a polyaxial locking plate via an anterolateral deltoid split approach from May 2008 to December 2011. We evaluated outcome parameters after a minimum follow-up period of 2.5 years (median 4.5 years, follow-up rate 62 %) including the age- and gender-dependent Constant score, the activities of daily living score, and the visual analog scale for both pain and subjective shoulder function.

Results: Of the 140 patients who underwent surgery, 114 were included in the follow-up and 71 completed the questionnaire. Fifteen patients (21 %) exhibited 2-fragment fractures, and 56 patients (79 %) exhibited 3- and 4-part fractures. The Constant score improved significantly (4.5 years: 70 ± 21, p < 0.001) between the first two follow-ups (6 weeks: 35 ± 14, 6 months: 56 ± 18, p < 0.001), and also between 6 months and 4.5 years post-surgery. At the final follow-up, the activities of daily living score had not reached pre-fracture levels (before trauma: 27 ± 5, 4.5 years: 20 ± 8, p < 0.001). A multivariate analysis showed that age has a more significant influence on the final outcome than fracture morphology or gender.

Conclusion: Although the less-invasive surgical procedure is a feasible treatment option in proximal humeral fractures with acceptable complications and considerable improvement during the first six months, a lengthy recovery time is required. The majority of our patients did not become pain-free or reach pre-fracture activity levels.

No MeSH data available.


Related in: MedlinePlus

Constant score at follow-up visits for each fracture type
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Fig3: Constant score at follow-up visits for each fracture type

Mentions: A significant improvement of 21 points was observed between 6 weeks and 6 months for all patients (6 weeks: 35 ± 14, 6 months: 56 ± 18; p < 0.001, Fig. 3). Further improvement was observed between 6 months and 4.5 years (4.5 years: 70 ± 21; p < 0.001). At the final follow-up, the scores for 2-part fractures were not significantly different from those for complex fractures (2-part fracture: 68 ± 24, 3- and 4-part fracture: 71 ± 20; p = 0.660).Fig. 3


Mid-term results of a less-invasive locking plate fixation method for proximal humeral fractures: a prospective observational study.

Bockmann B, Buecking B, Franz D, Zettl R, Ruchholtz S, Mohr J - BMC Musculoskelet Disord (2015)

Constant score at follow-up visits for each fracture type
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491200&req=5

Fig3: Constant score at follow-up visits for each fracture type
Mentions: A significant improvement of 21 points was observed between 6 weeks and 6 months for all patients (6 weeks: 35 ± 14, 6 months: 56 ± 18; p < 0.001, Fig. 3). Further improvement was observed between 6 months and 4.5 years (4.5 years: 70 ± 21; p < 0.001). At the final follow-up, the scores for 2-part fractures were not significantly different from those for complex fractures (2-part fracture: 68 ± 24, 3- and 4-part fracture: 71 ± 20; p = 0.660).Fig. 3

Bottom Line: The Constant score improved significantly (4.5 years: 70 ± 21, p < 0.001) between the first two follow-ups (6 weeks: 35 ± 14, 6 months: 56 ± 18, p < 0.001), and also between 6 months and 4.5 years post-surgery.At the final follow-up, the activities of daily living score had not reached pre-fracture levels (before trauma: 27 ± 5, 4.5 years: 20 ± 8, p < 0.001).The majority of our patients did not become pain-free or reach pre-fracture activity levels.

View Article: PubMed Central - PubMed

Affiliation: Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstrasse, 35043, Marburg, Germany. bockmann@med.uni-marburg.de.

ABSTRACT

Background: The optimal treatment for proximal humeral fractures remains under debate. In this article, we report the mid-term results of patients who underwent the less-invasive implantation of a polyaxial locking plate for displaced proximal humeral fractures.

Methods: This study included patients who were treated with a polyaxial locking plate via an anterolateral deltoid split approach from May 2008 to December 2011. We evaluated outcome parameters after a minimum follow-up period of 2.5 years (median 4.5 years, follow-up rate 62 %) including the age- and gender-dependent Constant score, the activities of daily living score, and the visual analog scale for both pain and subjective shoulder function.

Results: Of the 140 patients who underwent surgery, 114 were included in the follow-up and 71 completed the questionnaire. Fifteen patients (21 %) exhibited 2-fragment fractures, and 56 patients (79 %) exhibited 3- and 4-part fractures. The Constant score improved significantly (4.5 years: 70 ± 21, p < 0.001) between the first two follow-ups (6 weeks: 35 ± 14, 6 months: 56 ± 18, p < 0.001), and also between 6 months and 4.5 years post-surgery. At the final follow-up, the activities of daily living score had not reached pre-fracture levels (before trauma: 27 ± 5, 4.5 years: 20 ± 8, p < 0.001). A multivariate analysis showed that age has a more significant influence on the final outcome than fracture morphology or gender.

Conclusion: Although the less-invasive surgical procedure is a feasible treatment option in proximal humeral fractures with acceptable complications and considerable improvement during the first six months, a lengthy recovery time is required. The majority of our patients did not become pain-free or reach pre-fracture activity levels.

No MeSH data available.


Related in: MedlinePlus