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

2017-11

AUTHORS

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

ABSTRACT

PURPOSE: The 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 METHODS: Thirty-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. RESULTS: In 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%). CONCLUSION: The 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

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  • Identifiers

    URI

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

    DOI

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

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1090930728

    PUBMED

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


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