Failure and revision rates of proximal humeral fracture treatment with the use of a standardized treatment algorithm at a level-1 ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-09

AUTHORS

Jan Christoph Katthagen, Meret Huber, Svenja Grabowski, Alexander Ellwein, Gunnar Jensen, Helmut Lill

ABSTRACT

BACKGROUND: The aims of this study were to evaluate treatment failure and revision rates of proximal humeral fracture (PHF) treatment with a standardized treatment algorithm within the reality of a level-1 trauma center and to identify predictors of subsequent surgery. MATERIALS AND METHODS: The medical database of a level-1 trauma center was screened for all primary treatments of PHFs between January 2009 and June 2012. Medical records and imaging were analyzed to identify the fracture morphology, pre-existing diseases, revision surgeries and treatment failures (conversion to another treatment). The patients were asked about subsequent surgeries by phone. A functional outcome questionnaire was mailed to participating patients. RESULTS: Follow-up data were available for 423 of 521 patients (312 females, 111 males). The mean age at the time of primary treatment was 68.3 years; mean follow-up was 24.6 ± 12.3 months. The overall rate of mandatory re-operations was 15.6%, including a failure rate of 8.3%; another 7.6% of patients had additional arthroscopic surgeries. Treatment with anatomic hemi-prostheses was associated with the highest re-operation rates, and lowest outcomes. Involvement of the medial calcar region, complex fracture morphologies, cigarette smoking and alcohol-abuse were predictors for subsequent surgery. Patients without subsequent surgery had significantly higher functional outcome scores than patients with additional surgery. CONCLUSIONS: With the use of a standardized treatment algorithm no treatment modality was at significantly higher risk for having additional surgery. Complex fracture types, involvement of the medial calcar, cigarette-smoking and alcohol-abuse were associated with subsequent surgeries. LEVEL OF EVIDENCE: Level IV case series. More... »

PAGES

265-274

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10195-017-0457-8

DOI

http://dx.doi.org/10.1007/s10195-017-0457-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084919986

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28421293


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