Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions
Abstract Background The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. W...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03353-8 |
| _version_ | 1831683089129013248 |
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| author | N. Alispahic S. Brorson C. Bahrs A. Joeris A. Steinitz L. Audigé |
| author_facet | N. Alispahic S. Brorson C. Bahrs A. Joeris A. Steinitz L. Audigé |
| author_sort | N. Alispahic |
| collection | DOAJ |
| description | Abstract Background The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. We performed a systematic review to examine reported terms and definitions of complications after surgically-treated PHFs. Methods A literature search was conducted on PubMed, Cochrane Library, EMBASE, Scopus and WorldCat to identify clinical articles and book chapters on complications of PHF published from 2010 to 2017. Complication terms and definitions were extracted from each selected article independently by two reviewers and grouped according to a predefined scheme. Results From 1376 initial references, we selected 470 articles, of which 103 were reviewed in reverse chronological order until no further information was gained. Twelve book chapters were reviewed. We found 667 local event terms associated with complications after surgical treatment of PHFs. The most frequently used event terms were infection (52 references), nonunion (n = 42), malunion (n = 35), avascular necrosis (n = 27) and pain (n = 25). Overall, 345, 177, 257 and 102 local event terms were related to plating, nailing, arthroplasty and other surgical techniques, respectively. Radiological assessment was the basis for the majority of event terms and complication definitions. Thirty-six event definitions were extracted, mostly defining the terms “secondary fracture displacement”, “screw perforation/cutout”, “malunion”, “delayed healing” and “notching”. Conclusion Scientific literature on surgically-managed PHF uses different terms to describe complications and without approved definitions, which highlights a lack of agreement on adverse event terminology for PHFs. Defined event terms are mostly based on radiological observations. Consensus among shoulder surgeons on a core event set is indispensable to support the standardization of safety reporting for surgically-treated PHFs. |
| first_indexed | 2024-12-20T06:31:14Z |
| format | Article |
| id | doaj.art-0f724569b77b486380c53fa9d01e90fe |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-20T06:31:14Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-0f724569b77b486380c53fa9d01e90fe2022-12-21T19:50:08ZengBMCBMC Musculoskeletal Disorders1471-24742020-05-012111610.1186/s12891-020-03353-8Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitionsN. Alispahic0S. Brorson1C. Bahrs2A. Joeris3A. Steinitz4L. Audigé5Department of Orthopedic Surgery and Traumatology, University Hospital of BaselDepartment of Orthopedic Surgery, Zealand University Hospital and Department of Clinical Medicine, University of CopenhagenDepartment of Traumatology and Reconstructive Surgery, Eberhard Karls University Tübingen, BG Trauma Center TübingenAO Clinical Investigation and DocumentationCrossklinikDepartment of Orthopedic Surgery and Traumatology, University Hospital of BaselAbstract Background The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. We performed a systematic review to examine reported terms and definitions of complications after surgically-treated PHFs. Methods A literature search was conducted on PubMed, Cochrane Library, EMBASE, Scopus and WorldCat to identify clinical articles and book chapters on complications of PHF published from 2010 to 2017. Complication terms and definitions were extracted from each selected article independently by two reviewers and grouped according to a predefined scheme. Results From 1376 initial references, we selected 470 articles, of which 103 were reviewed in reverse chronological order until no further information was gained. Twelve book chapters were reviewed. We found 667 local event terms associated with complications after surgical treatment of PHFs. The most frequently used event terms were infection (52 references), nonunion (n = 42), malunion (n = 35), avascular necrosis (n = 27) and pain (n = 25). Overall, 345, 177, 257 and 102 local event terms were related to plating, nailing, arthroplasty and other surgical techniques, respectively. Radiological assessment was the basis for the majority of event terms and complication definitions. Thirty-six event definitions were extracted, mostly defining the terms “secondary fracture displacement”, “screw perforation/cutout”, “malunion”, “delayed healing” and “notching”. Conclusion Scientific literature on surgically-managed PHF uses different terms to describe complications and without approved definitions, which highlights a lack of agreement on adverse event terminology for PHFs. Defined event terms are mostly based on radiological observations. Consensus among shoulder surgeons on a core event set is indispensable to support the standardization of safety reporting for surgically-treated PHFs.http://link.springer.com/article/10.1186/s12891-020-03353-8Proximal humeral fracturesSurgical treatmentUnfavorable eventsAdverse eventsComplicationsSystematic literature review |
| spellingShingle | N. Alispahic S. Brorson C. Bahrs A. Joeris A. Steinitz L. Audigé Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions BMC Musculoskeletal Disorders Proximal humeral fractures Surgical treatment Unfavorable events Adverse events Complications Systematic literature review |
| title | Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions |
| title_full | Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions |
| title_fullStr | Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions |
| title_full_unstemmed | Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions |
| title_short | Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions |
| title_sort | complications after surgical management of proximal humeral fractures a systematic review of event terms and definitions |
| topic | Proximal humeral fractures Surgical treatment Unfavorable events Adverse events Complications Systematic literature review |
| url | http://link.springer.com/article/10.1186/s12891-020-03353-8 |
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