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It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures

Introduction: The aim of this study was to create a novel complication classification for osteosynthesis-related complications following angular stable plating of the proximal humerus subsuming the influence of these complications on clinical outcome in relation to fracture morphology and consequent...

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Autores principales: Siebenbürger, Georg, Neudeck, Rouven, Daferner, Mark Philipp, Fleischhacker, Evi, Böcker, Wolfgang, Ockert, Ben, Helfen, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095119/
https://www.ncbi.nlm.nih.gov/pubmed/37048639
http://dx.doi.org/10.3390/jcm12072556
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author Siebenbürger, Georg
Neudeck, Rouven
Daferner, Mark Philipp
Fleischhacker, Evi
Böcker, Wolfgang
Ockert, Ben
Helfen, Tobias
author_facet Siebenbürger, Georg
Neudeck, Rouven
Daferner, Mark Philipp
Fleischhacker, Evi
Böcker, Wolfgang
Ockert, Ben
Helfen, Tobias
author_sort Siebenbürger, Georg
collection PubMed
description Introduction: The aim of this study was to create a novel complication classification for osteosynthesis-related complications following angular stable plating of the proximal humerus subsuming the influence of these complications on clinical outcome in relation to fracture morphology and consequent revision strategies. A total of 1047 proximal humerus fractures with overall 193 osteosynthesis-associated complications (24.5%) were included. The following complication types could be clarified: complication Type 1 is defined by mild varus (<20°) or valgus displacement of the humeral head without resulting in a screw cutout through the humeral head cortex. Type 2a is defined by varus displacement (<20°) of the humeral head associated with screw cutout through the humeral head cortex. Type 2b complication is limited to displacement of the greater tuberosity, lesser tuberosity, or both tuberosities. Complication Type 2c is defined by severe varus dislocation (>20°) of the humeral head with screw cutout at the humeral head cortex. Complication Type 3 describes a displacement of the angular stable plate in the humeral shaft region with associated shaft-sided screw cutout, while the position of the humeral head remains static. Complication Type 4 is characterized by the occurrence of AVN with or without glenoidal affection (4a/b). Clinical outcome according to the constant score was mainly affected by type 2–4, leading to a deteriorated result. Depending on the type of complication, specific revision strategies can be considered. Additionally, more complex fracture patterns fostered the incidence of complications.
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spelling pubmed-100951192023-04-13 It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures Siebenbürger, Georg Neudeck, Rouven Daferner, Mark Philipp Fleischhacker, Evi Böcker, Wolfgang Ockert, Ben Helfen, Tobias J Clin Med Article Introduction: The aim of this study was to create a novel complication classification for osteosynthesis-related complications following angular stable plating of the proximal humerus subsuming the influence of these complications on clinical outcome in relation to fracture morphology and consequent revision strategies. A total of 1047 proximal humerus fractures with overall 193 osteosynthesis-associated complications (24.5%) were included. The following complication types could be clarified: complication Type 1 is defined by mild varus (<20°) or valgus displacement of the humeral head without resulting in a screw cutout through the humeral head cortex. Type 2a is defined by varus displacement (<20°) of the humeral head associated with screw cutout through the humeral head cortex. Type 2b complication is limited to displacement of the greater tuberosity, lesser tuberosity, or both tuberosities. Complication Type 2c is defined by severe varus dislocation (>20°) of the humeral head with screw cutout at the humeral head cortex. Complication Type 3 describes a displacement of the angular stable plate in the humeral shaft region with associated shaft-sided screw cutout, while the position of the humeral head remains static. Complication Type 4 is characterized by the occurrence of AVN with or without glenoidal affection (4a/b). Clinical outcome according to the constant score was mainly affected by type 2–4, leading to a deteriorated result. Depending on the type of complication, specific revision strategies can be considered. Additionally, more complex fracture patterns fostered the incidence of complications. MDPI 2023-03-28 /pmc/articles/PMC10095119/ /pubmed/37048639 http://dx.doi.org/10.3390/jcm12072556 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Siebenbürger, Georg
Neudeck, Rouven
Daferner, Mark Philipp
Fleischhacker, Evi
Böcker, Wolfgang
Ockert, Ben
Helfen, Tobias
It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title_full It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title_fullStr It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title_full_unstemmed It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title_short It Is Always the Same—A Complication Classification following Angular Stable Plating of Proximal Humeral Fractures
title_sort it is always the same—a complication classification following angular stable plating of proximal humeral fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095119/
https://www.ncbi.nlm.nih.gov/pubmed/37048639
http://dx.doi.org/10.3390/jcm12072556
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