title: Dynamic-locking-screw (DLS)-leads to less secondary screw perforations in proximal humerus fractures.
abstract: BACKGROUND
  Loss of reduction and screw perforation causes high failure rates in the treatment of proximal humerus fractures. The purpose of the present study was to evaluate the early postoperative complications using modern Dynamic Locking Screws (DLS 3.7) for plating of proximal humerus fractures.
  
  
  METHODS
  Between 03/2009 and 12/2010, 64 patients with acute proximal humerus fractures were treated by angular stable plate fixation using DLSs in a limited multi-centre study. Follow-up examinations were performed three, six, twelve and twenty-four weeks postoperatively and any complications were carefully collected.
  
  
  RESULTS
  56 of 64 patients were examined at the six-month follow-up. Complications were observed in 12 patients (22%). In five cases (9%), a perforation of the DLS 3.7 occurred.
  
  
  CONCLUSIONS
  Despite the use of modern DLS 3.7, the early complications after plating of proximal humerus fractures remain high. The potential advantage of the DLS 3.7 regarding secondary screw perforation has to be confirmed by future randomized controlled trials.
authors.forename: Thomas
authors.initials: T
authors.lastname: Freude
authors.forename: Steffen
authors.initials: S
authors.lastname: Schroeter
authors.forename: Michael
authors.initials: M
authors.lastname: Plecko
authors.forename: Christian
authors.initials: C
authors.lastname: Bahrs
authors.forename: Frank
authors.initials: F
authors.lastname: Martetschlaeger
authors.affiliation: Department of Traumatology and Reconstructive Surgery, BG Unfallklinik, Eberhard Karls Universitaet Tuebingen, Schnarrenbergstrasse 95, 72076 Tuebingen, Germany. kraus.tobias@gmail.com.
authors.forename: Tobias M
authors.initials: TM
authors.lastname: Kraus
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stoeckle
authors.forename: Stefan
authors.initials: S
authors.lastname: Doebele
mesh_terms: D000368:Aged; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D012784:Shoulder Fractures / Q000601:surgery*; D014193:Trauma Centers