Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes?
INTRODUCTION:To evaluate outcomes following open reduction and internal fixation of displaced proximal humeral fractures with regards to the surgeon's experience. MATERIAL AND METHODS:Patients were included undergoing ORIF by use of locking plates for displaced two-part surgical neck type proxi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC6219805?pdf=render |
| _version_ | 1818607504109600768 |
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| author | Tobias Helfen Georg Siebenbürger Evi Fleischhacker Niklas Biermann Wolfgang Böcker Ben Ockert |
| author_facet | Tobias Helfen Georg Siebenbürger Evi Fleischhacker Niklas Biermann Wolfgang Böcker Ben Ockert |
| author_sort | Tobias Helfen |
| collection | DOAJ |
| description | INTRODUCTION:To evaluate outcomes following open reduction and internal fixation of displaced proximal humeral fractures with regards to the surgeon's experience. MATERIAL AND METHODS:Patients were included undergoing ORIF by use of locking plates for displaced two-part surgical neck type proximal humeral fractures. Reduction and functional outcomes were compared between procedures that were conducted by trauma surgeons [TS], senior (>2 years after board certified) trauma surgeons [STS] and trauma surgeons performing ≥50 shoulder surgeries per year [SS]. Quality of reduction was measured on postoperative x-rays. Functional outcomes were assessed by gender- and age-related Constant Score (nCS). Secondary outcome measures were complication and revision rates. RESULTS:Between 2002-2014 (12.5 years) n = 278 two-part surgical neck type humeral fractures (AO 11-A2, 11-A3) were included. Open reduction and internal fixation was performed with the following educational levels: [TS](n = 68, 25.7%), [STS](n = 110, 41.5%) and [SS](n = 77, 29.1%). Functional outcome (nCS) increased with each higher level of experience and was significantly superior in [SS] (93.3) vs. [TS] (79.6; p = 0.01) vs. [STS] (83.0; p = 0.05). [SS] (7.8%) had significantly less complications compared with [TS] (11.3%; p = 0.003) and [STS](11.7%; p = 0.01) moreover significantly less revision rates (3.9%) vs. [TS](8.2%) and [STS](7.4%) (p<0.001). Primary revision was necessary in 13 cases (4.7%) due to malreduction of the fracture. CONCLUSION:Quality of reduction and functional outcomes following open reduction and internal fixation of displaced two-part surgical neck fractures are related to the surgeon's experience. In addition, complications and revision rates are less frequent if surgery is conducted by a trauma surgeon performing ≥50 shoulder surgeries per year. |
| first_indexed | 2024-12-16T14:27:48Z |
| format | Article |
| id | doaj.art-a435991a39514afc9a116867407d9d70 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T14:27:48Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a435991a39514afc9a116867407d9d702022-12-21T22:28:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011311e020704410.1371/journal.pone.0207044Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes?Tobias HelfenGeorg SiebenbürgerEvi FleischhackerNiklas BiermannWolfgang BöckerBen OckertINTRODUCTION:To evaluate outcomes following open reduction and internal fixation of displaced proximal humeral fractures with regards to the surgeon's experience. MATERIAL AND METHODS:Patients were included undergoing ORIF by use of locking plates for displaced two-part surgical neck type proximal humeral fractures. Reduction and functional outcomes were compared between procedures that were conducted by trauma surgeons [TS], senior (>2 years after board certified) trauma surgeons [STS] and trauma surgeons performing ≥50 shoulder surgeries per year [SS]. Quality of reduction was measured on postoperative x-rays. Functional outcomes were assessed by gender- and age-related Constant Score (nCS). Secondary outcome measures were complication and revision rates. RESULTS:Between 2002-2014 (12.5 years) n = 278 two-part surgical neck type humeral fractures (AO 11-A2, 11-A3) were included. Open reduction and internal fixation was performed with the following educational levels: [TS](n = 68, 25.7%), [STS](n = 110, 41.5%) and [SS](n = 77, 29.1%). Functional outcome (nCS) increased with each higher level of experience and was significantly superior in [SS] (93.3) vs. [TS] (79.6; p = 0.01) vs. [STS] (83.0; p = 0.05). [SS] (7.8%) had significantly less complications compared with [TS] (11.3%; p = 0.003) and [STS](11.7%; p = 0.01) moreover significantly less revision rates (3.9%) vs. [TS](8.2%) and [STS](7.4%) (p<0.001). Primary revision was necessary in 13 cases (4.7%) due to malreduction of the fracture. CONCLUSION:Quality of reduction and functional outcomes following open reduction and internal fixation of displaced two-part surgical neck fractures are related to the surgeon's experience. In addition, complications and revision rates are less frequent if surgery is conducted by a trauma surgeon performing ≥50 shoulder surgeries per year.http://europepmc.org/articles/PMC6219805?pdf=render |
| spellingShingle | Tobias Helfen Georg Siebenbürger Evi Fleischhacker Niklas Biermann Wolfgang Böcker Ben Ockert Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? PLoS ONE |
| title | Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? |
| title_full | Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? |
| title_fullStr | Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? |
| title_full_unstemmed | Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? |
| title_short | Open reduction and internal fixation of displaced proximal humeral fractures. Does the surgeon's experience have an impact on outcomes? |
| title_sort | open reduction and internal fixation of displaced proximal humeral fractures does the surgeon s experience have an impact on outcomes |
| url | http://europepmc.org/articles/PMC6219805?pdf=render |
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