Surgical treatment of proximal humeral fractures with the transosseous suture fixation
Abstract Background The surgical treatment of displaced proximal humeral fractures is commonly affected by implant-related complications. We evaluated the functional and radiographic results of transosseous suture fixation in a series of displaced proximal humeral fractures (PHF). Methods Sixty-four...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02555-7 |
| _version_ | 1811212755976323072 |
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| author | J. Miquel R. Martínez F. Santana P. Marimon C. Torrens |
| author_facet | J. Miquel R. Martínez F. Santana P. Marimon C. Torrens |
| author_sort | J. Miquel |
| collection | DOAJ |
| description | Abstract Background The surgical treatment of displaced proximal humeral fractures is commonly affected by implant-related complications. We evaluated the functional and radiographic results of transosseous suture fixation in a series of displaced proximal humeral fractures (PHF). Methods Sixty-four patients were retrospectively classified by age, sex, and the Neer fracture classification. Two-part greater tuberosity (2pGT) displaced fractures and 3-part (varus and valgus) and 4-part valgus impacted fractures were managed with fragment reduction and transosseous suture fixation. Patients with minimum follow-up of 24 months and assessed with the Constant-Murley score (CMS) were included. Radiological and medical complications, as well as reinterventions were also recorded. Results Forty-six patients with a mean follow-up of 58 (24–132) and a mean age of 58 years old were analyzed. Patients with 2pGT (n = 10) fractures had a CMS of 76 points (59–89); patients with 3-part fractures (n = 22) had a score of 67 points (13–91); and those with 4-part fractures (n = 14) had a score of 64 (24–76) points. The overall complication rate was 6 out of 46, and 4 patients required reintervention for different reasons. Patients presenting with 3-part varus fractures had significantly lower functional outcomes scores (p = 0.007). Humeral head osteonecrosis was present in 9 patients and significantly affected the functional outcomes (p < 0.05). However, only three out of nine patients with osteonecrosis required subsequent surgery at the indicated follow-up. Conclusions The fracture reduction and transosseous fixation technique represents a safe technique with low complication and reintervention rates. The presence of humeral head necrosis did not lead to subsequent surgical intervention because no hardware had protruded. Level of evidence Level IV, retrospective study |
| first_indexed | 2024-04-12T05:35:42Z |
| format | Article |
| id | doaj.art-859fd593c7ac4b2fa657a12988a730aa |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-12T05:35:42Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-859fd593c7ac4b2fa657a12988a730aa2022-12-22T03:45:53ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-06-011611710.1186/s13018-021-02555-7Surgical treatment of proximal humeral fractures with the transosseous suture fixationJ. Miquel0R. Martínez1F. Santana2P. Marimon3C. Torrens4Corporació Sanitària Parc TaulíConsorci Sanitari de l’AnoiaParc de Salut MarConsorci Sanitari de l’AnoiaParc de Salut MarAbstract Background The surgical treatment of displaced proximal humeral fractures is commonly affected by implant-related complications. We evaluated the functional and radiographic results of transosseous suture fixation in a series of displaced proximal humeral fractures (PHF). Methods Sixty-four patients were retrospectively classified by age, sex, and the Neer fracture classification. Two-part greater tuberosity (2pGT) displaced fractures and 3-part (varus and valgus) and 4-part valgus impacted fractures were managed with fragment reduction and transosseous suture fixation. Patients with minimum follow-up of 24 months and assessed with the Constant-Murley score (CMS) were included. Radiological and medical complications, as well as reinterventions were also recorded. Results Forty-six patients with a mean follow-up of 58 (24–132) and a mean age of 58 years old were analyzed. Patients with 2pGT (n = 10) fractures had a CMS of 76 points (59–89); patients with 3-part fractures (n = 22) had a score of 67 points (13–91); and those with 4-part fractures (n = 14) had a score of 64 (24–76) points. The overall complication rate was 6 out of 46, and 4 patients required reintervention for different reasons. Patients presenting with 3-part varus fractures had significantly lower functional outcomes scores (p = 0.007). Humeral head osteonecrosis was present in 9 patients and significantly affected the functional outcomes (p < 0.05). However, only three out of nine patients with osteonecrosis required subsequent surgery at the indicated follow-up. Conclusions The fracture reduction and transosseous fixation technique represents a safe technique with low complication and reintervention rates. The presence of humeral head necrosis did not lead to subsequent surgical intervention because no hardware had protruded. Level of evidence Level IV, retrospective studyhttps://doi.org/10.1186/s13018-021-02555-7Proximal humeral fracturesTransosseous fixationOpen reduction and internal fixation |
| spellingShingle | J. Miquel R. Martínez F. Santana P. Marimon C. Torrens Surgical treatment of proximal humeral fractures with the transosseous suture fixation Journal of Orthopaedic Surgery and Research Proximal humeral fractures Transosseous fixation Open reduction and internal fixation |
| title | Surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| title_full | Surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| title_fullStr | Surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| title_full_unstemmed | Surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| title_short | Surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| title_sort | surgical treatment of proximal humeral fractures with the transosseous suture fixation |
| topic | Proximal humeral fractures Transosseous fixation Open reduction and internal fixation |
| url | https://doi.org/10.1186/s13018-021-02555-7 |
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