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Valgising angular stable plate fixation in the treatment of multifragmentary proximal humeral fractures in elderly patients

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The frequency of proximal humeral fractures shows an increasing tendency, especially in the elderly, who are frequently affected by osteoporosis. The adequate treatment of complex, displaced fractures poses a serious challenge. Among surgical treatment options, osteosynthesis with an angular stable plate is preferred, however, the implant-related complication rate may be exceptionally high. In our present study, we report the short-term outcomes of our new method of valgising angular stable plate fixation which we use for multifragmentary, displaced proximal humeral fractures in elderly patients.

Materials and methods

We retrospectively evaluated the clinical and radiological outcomes of 52 patients (46 female and 6 male, age: 71.9 ± 9.6) who suffered dislocated three- or four-part fractures and underwent valgising angular stable plate fixation.

Results

Mean follow-up time was 17.3 months, while the functional outcomes were as following: excellent in 26, good in 18, moderate in 5 and poor in 3 patients. The mean Constant-Murley Score was 82.5 ± 11.2. Functional outcomes only showed significant correlation (p = 0.031) with age and were proven unrelated to fracture type, BMI and known primary diseases. The cumulative complication rate was 9.6% and revision rate was 5.8%. Neurological deficit, pseudoarthrosis or avascular humeral head necrosis did not occur during the follow-up period.

Conclusions

Valgising angular stable plate fixation that we apply for proximal humeral fractures provided favourable functional outcomes and a low postoperative complication rate due to the optimal head and plate placement. The method is especially effective for the treatment of displaced three- and four-part fractures with weakened, osteoporotic bone structure.

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Data availability

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.

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Funding

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Authors and Affiliations

  1. General, Visceral, Thoracic and Trauma Surgery, Surgical Orthopaedics, Die Filderklinik gGmbH, Im Haberschlai 7, 70794, Filderstadt-Bonlanden, Germany

    Máté Burkus, A. Bruch, E. M. Bergmann, M. Karahodzic-Franjic & M. Zdichavsky

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  1. Máté Burkus
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  2. A. Bruch
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All authors contributed to the study conception and design. All authors read and approved the final manuscript.

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Correspondence to Máté Burkus.

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Ethical approval was waived by the local Ethics Committee of University Tübingen in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Burkus, M., Bruch, A., Bergmann, E.M. et al. Valgising angular stable plate fixation in the treatment of multifragmentary proximal humeral fractures in elderly patients. Arch Orthop Trauma Surg 144, 1637–1645 (2024). https://doi.org/10.1007/s00402-024-05218-4

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