Detection of primary screw perforation in locking plate osteosynthesis of proximal humerus fracture by intra-operative 3D fluoroscopy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-07-31

AUTHORS

Jan Theopold, Kevin Weihs, Bastian Marquaß, Christoph Josten, Pierre Hepp

ABSTRACT

PurposeThe purpose of this study was to identify the rate of primary screw perforations after osteosynthesis of proximal humerus fractures with intra-operative 3D fluoroscopy and to analyse the rate of secondary screw perforations as well as complications, outcome, and revision surgeries after a minimum of 12 months.Materials and methodsThirty-three patients (20 female, 13 male, median age 67 years, range 35–85 years) with displaced proximal humerus fractures were included. After reduction and fixation, an intra-operative 3D fluoroscopy was performed to evaluate primary screw perforations (PS) and screws with “near perforation” (nPS). These screws were changed intra-operatively. Patients were followed-up for a minimum of 12 months. Clinical and radiological parameters, such as secondary screw perforation, secondary loss of reduction, or functional outcome, were investigated.ResultsIn six patients (18.2%), humeral head screws were changed due to primary PS (n = 2) or nPS (n = 4) after the intra-operative 3D fluoroscopy. Follow-up revealed an adapted constant score (%CMS) of 76.2% after a mean follow-up of 17.7 months. Two secondary screw perforations were observed (6%). Loss of reduction was observed in eight patients (24.2%).ConclusionThe intra-operative 3D reveals a high rate of primary screw perforations or near perforations. Immediate change of these screws may lead to a lower rate of secondary screw perforations and, therefore, reduce post-operative complications. More... »

PAGES

1491-1498

References to SciGraph publications

  • 2011-06-01. Die winkelstabile Platte zur Behandlung der 3- und 4-Fragmentfraktur am proximalen Humerus in OBERE EXTREMITÄT
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  • 2015-01-01. Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2014-03-30. Behandlung proximaler Humerusfrakturen in Deutschland in DER UNFALLCHIRURG
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  • 2016-02-01. The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate in MUSCULOSKELETAL SURGERY
  • 2014-07-01. Klinisches Outcome (Median 5 Jahre) nach winkelstabiler Plattenosteosynthese von 228 Patienten mit dislozierter proximaler Humerusfraktur in OBERE EXTREMITÄT
  • 2015-10-07. Additional calcar support using a blade device reduces secondary varus displacement following reconstruction of the proximal humerus: a prospective study in EUROPEAN JOURNAL OF MEDICAL RESEARCH
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00402-017-2763-2

    DOI

    http://dx.doi.org/10.1007/s00402-017-2763-2

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28762134


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