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European Journal of Trauma and Emergency Surgery

Erschienen in:

24.05.2020 | Original Article

Complication rate after operative treatment of three- and four-part fractures of the proximal humerus: locking plate osteosynthesis versus proximal humeral nail

verfasst von: Greta Lorenz, Wolfgang Schönthaler, Wolfgang Huf, Micha Komjati, Christian Fialka, Sandra Boesmueller

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2021

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Abstract

Purpose

There is still disagreement regarding the optimal surgical treatment of three- and four-part fractures of the proximal humerus. The aim of this monocentric, retrospective study was to compare the complication rate of internal fixation with a locking plate versus proximal humeral nailing after a one-year follow-up.

Methods

From 2005 to 2016, 292 patients suffered a fracture of the proximal humerus and were treated surgically at our level-I trauma center. According to the inclusion criteria, 50 patients were included in this study: 19 of these (11 three-part fractures and 8 four-part fractures) were treated with a proximal humeral nail (HN) and 31 (12 three-part fractures and 19 four-part fractures) with a locking plate (LP) osteosynthesis. Classification was performed according to the Hertel classification. At a 1-year follow-up, the complication rate of the two treatment methods was compared.

Results

Twenty patients (40%) suffered at least one complication. Of these, six patients (12%) were treated with a HN and 14 (28%) with a LP (p = 0.39). The most frequent complication was screw perforation (22%), followed by non-union (16%). Humeral head necrosis (10%) occurred only in the LP cohort. One wound infection occurred in a patient treated with a HN. Four-part fractures were treated more frequently with a LP. However, the difference was non-significant in this sample (p = 0.186).

Conclusions

The results of our study provide some evidence that in terms of complication rate, both treatment options are comparable for internal fixation of three- and four-part fractures of the proximal humerus. The type of fracture seems to be decisive for the choice of implant.

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Titel: Complication rate after operative treatment of three- and four-part fractures of the proximal humerus: locking plate osteosynthesis versus proximal humeral nail
verfasst von: Greta Lorenz
Wolfgang Schönthaler
Wolfgang Huf
Micha Komjati
Christian Fialka
Sandra Boesmueller
Publikationsdatum: 24.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 6/2021
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01380-7

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