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Quality of life, functional and radiological outcomes of treatment of three-part and four-part proximal humerus fractures with locking plates and comparison in young versus older than 70 years: a retrospective cohort study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Verify if the use of locking plates in displaced three- and four-part proximal humerus fractures has meant an improvement even in patients over 70 years of age.

Material and methods

We performed surgery with locking plate fixation in 56 consecutive patients with three- and four-part proximal humerus fractures according to Neer's classification between 1/1/15 and 12/31/20 at our Hospital. Patient satisfaction, quality of life, functionality and radiological variables, as well as the comparison between patients older and younger than 70 years were the main outcomes. Likewise, factors and complications that may have influenced these variables were analyzed as secondary outcomes. The analysis of all these variables was performed after a minimum follow-up time of 24 months after surgery.

Results

51 patients (92%) ended up satisfied or very satisfied according to the SF-36 test and with no disability or mild disability according to the DASH Score questionnaire. 46 patients (82%) obtained a satisfactory or excellent result according to the Neer scale modified by Cofield and 38 (68%) a good or excellent function according to the Constant Murley questionnaire. In 47 cases (84%) good radiological alignment was observed. Complications occurred in 20 patients (36%). The complications and the results of the SF-36, DASH Score, Neer scale modified by Cofield and Constant Murley tests depended on the radiological alignment (p = 0.009, p = 0.006, p = 0.025, p = 0.0008 and p = 0.0004). There were 37 patients younger than 70 years and 19 older than 70 years with no statistically significant differences when comparing the two groups.

Conclusions

This study demonstrates that satisfactory results can be obtained with osteosynthesis with locking plates in displaced proximal humerus fractures even in patients older than 70 years of age.

Level of evidence III

Retrospective Cohort, Treatment Study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, University Hospital La Princesa, Universidad Autónoma de Madrid, C/Diego de León 62, 28006, Madrid, Spain

    Ignacio Descalzo Godoy, Paula Velasco Alcalde, Alberto Del Olmo Galeano, Julián Del Río Hortelano, David Martínez Velez & Julián Fernández González

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  1. Ignacio Descalzo Godoy
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  2. Paula Velasco Alcalde
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  3. Alberto Del Olmo Galeano
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Correspondence to Ignacio Descalzo Godoy.

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All the different phases of the work comply with the ethical standards established in the Declaration of Helsinki.

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During the follow-up period, the patients who participated in the study expressed their oral and written informed consent for the anamnesis and physical examination, for the clinical follow-up, for the performance of complementary tests and for the surgical intervention.

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Descalzo Godoy, I., Velasco Alcalde, P., Del Olmo Galeano, A. et al. Quality of life, functional and radiological outcomes of treatment of three-part and four-part proximal humerus fractures with locking plates and comparison in young versus older than 70 years: a retrospective cohort study. Eur J Orthop Surg Traumatol 34, 415–423 (2024). https://doi.org/10.1007/s00590-023-03675-y

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