1. Factors associated with maintaining reduction following locking plate fixation of proximal humerus fractures: a population-based retrospective cohort study
- Author
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Martin Bouliane, MD, FRCSC, Anelise Silveira, PT, MRSc, AlJarrah AlEidan, MD, Luke Heinrichs, MD, Sung Hyun Kang, MSc, David M. Sheps, MD, MSc, MBA, FRCSC, and Lauren Beaupre, PT, PhD
- Subjects
Locking plate fixation ,proximal humerus fractures ,loss of reduction ,biomechanics ,reoperation ,prognostic factors ,Orthopedic surgery ,RD701-811 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background: Loss of reduction (LoR) can occur after locking plate fixation of proximal humerus fractures (PHFs). This study determined biomechanical features of fracture fixation associated with preventing LoR postoperatively. One-year reoperation rates were also compared between those with/without LoR. Methods: Population-based administrative data for 359 adults treated using a locking plate for PHF between 2010 and 2016 were examined. Two trained assessors reviewed standardized shoulder radiographs. LoR (Yes/No) was defined as any fracture displacement >0.5 cm, and/or >10° change in neck-shaft angle (NSA) alignment relative to intraoperative imaging. Multiple logistic regression assessed how the following affected maintaining reduction: (1) sex, (2) age, (3) Neer classification, (4) shaft impaction (SI), (5) shaft medialization (SM), (6) calcar reduction (CR), (7) NSA alignment, and (8) screw use. Results: LoR was seen in 79 (22%) patients. LoR was significantly associated with increasing age (odds ratio [OR] = 1.06/yr, P < .001), fracture severity (4-part vs. 2-part fracture; OR = 4.63, P = .001), and varus NSA alignment (
- Published
- 2020
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