title: Is loss of fixation following locked plating of proximal humeral fractures related to the number of screws and their positions in the humeral head?
abstract: The aim of the study was to examine the correlation between the chosen position of screws and the complications observed in patients who underwent locked plating of proximal humeral fractures. We evaluated radiographs of 367 patients treated by locked-plating for proximal humeral fractures. Radiographs were taken at one day, 6 weeks, 3 months and 6 months after surgery, and were analyzed for secondary fracture displacement, loss of fixation, cutting out of screws and necrosis of the humeral head. Secondary loss of fixation occurred in 58 cases (15.8%) and among those cutting out of screws was observed in 25 cases (6.8%). In cases of secondary loss of fixation a mean of 6.7 screws were used to fix the fracture (vs 6.6, P=0.425). There was neither significant correlation between position of screws and the occurrence of postoperative loss of fixation in Spearman correlation nor relationship from backward logistic regression analysis. Loss of fixation following locked plating of proximal humeral fractures does not relate to the number of screws and their positions in the humeral head. In consequence, anatomic fracture reduction and restoration of the humeral head-shaft angle are still important factors and should not be disregarded.
authors.affiliation: Department of Trauma and Orthopedic Surgery, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Maddah
authors.affiliation: Department of Trauma and Orthopedic Surgery, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Wolf C
authors.initials: WC
authors.lastname: Prall
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Lucas
authors.initials: L
authors.lastname: Geyer
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirth
authors.affiliation: Department of Trauma and Orthopedic Surgery, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Wolf
authors.initials: W
authors.lastname: Mutschler
authors.affiliation: Department of Trauma and Orthopedic Surgery, Ludwig-Maximilians-University , Munich, Germany.
authors.forename: Ben
authors.initials: B
authors.lastname: Ockert
keywords: angular stable plating; loss of fixation; proximal humeral fracture; screw cutout; secondary fracture displacement