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Long-term results after non-plate head-preserving fixation of proximal humeral fractures

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Abstract

A retrospective study was conducted to evaluate displaced proximal humeral fractures treated with a non-plate head-preserving fixation and to detect factors predicting functional outcome. After a median follow-up period of 79.7 months, 105 patients with nine A-fractures, 36 B-fractures and 60 C-fractures (nine two-part-fractures, 41 three-part fractures and 55 four-part fractures) were assessed. Functional outcome was measured based on the Constant and UCLA scores. Of all patients, 70–75% had excellent or good Constant and UCLA scores. In 74% a good or satisfactory quality of initial reduction fracture was achieved. About one-fifth (21%) of the fractures showed a secondary displacement. Twenty-seven percent of the patients had signs of humeral head necrosis and 22% had implant related problems. There were significant correlations between a high final score and young age, low AO fracture severity, good quality of fracture reduction and residual osseous deformity, absence of secondary fracture displacement, implant-related complications, shoulder arthrosis and humeral head necrosis at the time of follow-up. In conclusion, the non-plate head-preserving fixation of proximal humeral fractures is an alternative treatment for displaced proximal humeral fractures. Especially in severely displaced C-fractures in older patients, non-anatomical reduction leads to a high rate of secondary displacement, residual osseous deformity and only a fair shoulder function. For these cases alternative methods such as prosthetic replacement should be chosen.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Klinik für Unfall- und Wiederherstellungschirurgie, BG-Unfallklinik Tübingen, Eberhard-Karls-Universität Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany

    Christian Bahrs, Andreas Badke, Bernd Rolauffs, Kuno Weise & Sebastian Zipplies

  2. Institut für Medizinische Biometrie, Eberhard-Karls-Universität Tübingen, Westbahnhofstr. 55, 72070, Tübingen, Germany

    Klaus Dietz

  3. Klinik für Unfall- und Wiederherstellungschirurgie, Caritas-Krankenhaus Bad Mergentheim, Uhlandstr. 7, 97980, Bad Mergentheim, Germany

    Christoph Eingartner

Authors
  1. Christian Bahrs
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  2. Andreas Badke
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  3. Bernd Rolauffs
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  4. Kuno Weise
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  5. Sebastian Zipplies
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  6. Klaus Dietz
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  7. Christoph Eingartner
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Correspondence to Andreas Badke.

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Bahrs, C., Badke, A., Rolauffs, B. et al. Long-term results after non-plate head-preserving fixation of proximal humeral fractures. International Orthopaedics (SICOT) 34, 883–889 (2010). https://doi.org/10.1007/s00264-009-0848-4

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  • DOI: https://doi.org/10.1007/s00264-009-0848-4

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