Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system
Abstract Background Proximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of pat...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06176-5 |
| _version_ | 1811176006352896000 |
|---|---|
| author | Michael Kimmeyer Jonas Schmalzl Verena Rentschler Malik Jessen Christian Gerhardt Lars-Johannes Lehmann |
| author_facet | Michael Kimmeyer Jonas Schmalzl Verena Rentschler Malik Jessen Christian Gerhardt Lars-Johannes Lehmann |
| author_sort | Michael Kimmeyer |
| collection | DOAJ |
| description | Abstract Background Proximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of patients treated with a CFR-PEEK plate. Methods Patients with proximal humerus fractures treated with a CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) were included. In follow-up examination, age and gender adjusted Constant-Murley Score (ACS), Subjective Shoulder Value (SSV), Quick Disabilities of the Arm, Shoulder and Hand Score (QDASH) and pain score (Visual Analog Scale (VAS)) were analyzed. General condition at follow-up was measured by European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L). Range of motion was recorded. In addition, radiographs at follow-up, unfavorable events and revision rate were analyzed. Results In total, 98 patients (66.0 ± 13.2 years, 74 females, 24 males) were reexamined. Mean follow-up was 27.6 ± 13.2 months. There were 15 2-part, 28 3-part and 55 4-part fractures. The functional scores showed good results: SSV 83.3 ± 15.6%, QDASH 13.1 ± 17.0 and ACS 80.4 ± 16.0. A 4-part-fracture, head split component, nonanatomic head shaft reposition and preoperative radiological signs of osteoarthritis were significant negative predictors for poorer clinical scores. Unfavourable events were observed in 27 patients (27.6%). Revision surgery was performed in 8 (8.2%) patients. Risk factors for an unfavourable event were female gender, age of 50 years and older, diabetes, affected dominant hand, 4-part fracture, head split and preoperative radiological signs of osteoarthritis. Conclusion There are several advantages of the CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) such as the polyaxial screw placement and higher stability of locking screws. In summary, the CFR-PEEK plate osteosynthesis is a good alternative with comparable clinical results and some biomechanical advantages. Proximal humerus fractures show good clinical results after treatment with a CFR-PEEK plate. The revision rate and the risk of unfavorable events are not increased compared to conventional titanium plate osteosynthesis. Level of evidence IV |
| first_indexed | 2024-04-10T19:44:59Z |
| format | Article |
| id | doaj.art-2c02ea985113443bbd2de7b5e7176a30 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-10T19:44:59Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-2c02ea985113443bbd2de7b5e7176a302023-01-29T12:02:11ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-0124111110.1186/s12891-023-06176-5Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate systemMichael Kimmeyer0Jonas Schmalzl1Verena Rentschler2Malik Jessen3Christian Gerhardt4Lars-Johannes Lehmann5Department of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics KarlsruheDepartment of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital WuerzburgDepartment of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics KarlsruheDepartment of Trauma Surgery, University Clinic Rechts Der Isar, Technical University MunichDepartment of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics KarlsruheDepartment of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics KarlsruheAbstract Background Proximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of patients treated with a CFR-PEEK plate. Methods Patients with proximal humerus fractures treated with a CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) were included. In follow-up examination, age and gender adjusted Constant-Murley Score (ACS), Subjective Shoulder Value (SSV), Quick Disabilities of the Arm, Shoulder and Hand Score (QDASH) and pain score (Visual Analog Scale (VAS)) were analyzed. General condition at follow-up was measured by European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L). Range of motion was recorded. In addition, radiographs at follow-up, unfavorable events and revision rate were analyzed. Results In total, 98 patients (66.0 ± 13.2 years, 74 females, 24 males) were reexamined. Mean follow-up was 27.6 ± 13.2 months. There were 15 2-part, 28 3-part and 55 4-part fractures. The functional scores showed good results: SSV 83.3 ± 15.6%, QDASH 13.1 ± 17.0 and ACS 80.4 ± 16.0. A 4-part-fracture, head split component, nonanatomic head shaft reposition and preoperative radiological signs of osteoarthritis were significant negative predictors for poorer clinical scores. Unfavourable events were observed in 27 patients (27.6%). Revision surgery was performed in 8 (8.2%) patients. Risk factors for an unfavourable event were female gender, age of 50 years and older, diabetes, affected dominant hand, 4-part fracture, head split and preoperative radiological signs of osteoarthritis. Conclusion There are several advantages of the CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) such as the polyaxial screw placement and higher stability of locking screws. In summary, the CFR-PEEK plate osteosynthesis is a good alternative with comparable clinical results and some biomechanical advantages. Proximal humerus fractures show good clinical results after treatment with a CFR-PEEK plate. The revision rate and the risk of unfavorable events are not increased compared to conventional titanium plate osteosynthesis. Level of evidence IVhttps://doi.org/10.1186/s12891-023-06176-5Proximal humerus fracturesAngle-stable osteosynthesisPolyetheretherketoneOpen reduction internal fixationAdverse event |
| spellingShingle | Michael Kimmeyer Jonas Schmalzl Verena Rentschler Malik Jessen Christian Gerhardt Lars-Johannes Lehmann Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system BMC Musculoskeletal Disorders Proximal humerus fractures Angle-stable osteosynthesis Polyetheretherketone Open reduction internal fixation Adverse event |
| title | Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| title_full | Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| title_fullStr | Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| title_full_unstemmed | Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| title_short | Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| title_sort | functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system |
| topic | Proximal humerus fractures Angle-stable osteosynthesis Polyetheretherketone Open reduction internal fixation Adverse event |
| url | https://doi.org/10.1186/s12891-023-06176-5 |
| work_keys_str_mv | AT michaelkimmeyer functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem AT jonasschmalzl functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem AT verenarentschler functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem AT malikjessen functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem AT christiangerhardt functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem AT larsjohanneslehmann functionalresultsandunfavorableeventsaftertreatmentofproximalhumerusfracturesusinganewlockingplatesystem |