Assessment of Complication Risk in the Treatment of Proximal Humerus Fractures: A Retrospective Analysis of 4019 Patients

被引：10

作者：

Henkelmann, Ralf ^{[1
]}

Hepp, Pierre ^{[1
]}

Mester, Bastian ^{[2
]}

Dudda, Marcel ^{[2
]}

Braun, Philipp-Johannes ^{[3
]}

Kleen, Sebastian ^{[3
]}

Zellner, Johannes ^{[4
]}

Galler, Michael ^{[5
]}

Koenigshausen, Matthias ^{[6
]}

Schildhauer, Thomas A. ^{[6
]}

Saier, Tim ^{[7
]}

Trulson, Inga ^{[8
]}

Dey Hazra, Rony-Orijit ^{[9
]}

Lill, Helmut ^{[9
]}

Glaab, Richard ^{[10
]}

Bolt, Basil ^{[10
]}

Wagner, Marcus ^{[11
]}

Raschke, Michael J. ^{[12
]}

Katthagen, Jan Christoph ^{[12
]}

机构：

[1] Univ Leipzig, Dept Orthoped Trauma & Plast Surg, Div Arthroscop & Special Joint Surg Sports Injurie, Liebigstr 20, D-04103 Leipzig, Germany

[2] Univ Hosp Essen, Dept Trauma Hand & Reconstruct Surg, Hufelandstr 55, D-45147 Essen, Germany

[3] BG Hosp Unfallkrankenhaus Berlin gGmbH, Dept Trauma & Orthopaed Surger, Warener Str 7, D-12683 Berlin, Germany

[4] Sporthopaedicum Regensburg, D-93053 Regensburg, Germany

[5] Caritas Hosp St Josef, Dept Trauma Surg, Landshuter Str 65, D-93053 Regensburg, Germany

[6] Ruhr Univ Bochum, Univ Bergmannsheil Bochum, Dept Gen & Trauma Surg, Burkle de la Camp Pl 1, D-44789 Bochum, Germany

[7] BG Trauma Ctr Murnau, Dept Trauma Surg, D-82418 Murnau, Germany

[8] Tech Univ Munich, Inst Lab Med, German Heart Ctr, Lazarettstr 36, D-80636 Munich, Germany

[9] DIAKOVERE Friederikenstift, Dept Orthopaed Surg & Traumatol, Humboldtstr 5, D-30169 Hannover, Germany

[10] Cantonal Hosp Aarau, Dept Traumatol, CH-5001 Aarau, Switzerland

[11] Univ Leipzig, Inst Med Informat Stat & Epidemiol IMISE, Hartelstr 16-18, D-04107 Leipzig, Germany

[12] Univ Hosp Muenster, Dept Trauma Hand & Reconstruct Surg, Albert Schweitzer Campus 1, D-48149 Munster, Germany

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 05期

关键词：

proximal humeral fracture; complication; operative treatment; nonoperative treatment; risk analysis; PLATE FIXATION;

D O I：

10.3390/jcm12051844

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

(1) Background: The treatment of proximal humeral fractures (PHFs) is debated controversially. Current clinical knowledge is mainly based on small single-center cohorts. The goal of this study was to evaluate the predictability of risk factors for complications after the treatment of a PHF in a large clinical cohort in a multicentric setting. (2) Methods: Clinical data of 4019 patients with PHFs were retrospectively collected from 9 participating hospitals. Risk factors for local complications of the affected shoulder were assessed using bi- and multivariate analyses. (3) Results: Fracture complexity with n = 3 or more fragments, cigarette smoking, age over 65 years, and female sex were identified as predictable individual risk factors for local complications after surgical therapy as well as the combination of female sex and smoking and the combination of age 65 years or older and ASA class 2 or higher. (4) Conclusion: Humeral head preserving reconstructive surgical therapy should critically be evaluated for patients with the risk factors abovementioned.

引用

页数：12

共 24 条

[1]

[Anonymous], 2018, R LANG ENV STAT COMP

[2] Locking plate fixation of proximal humerus fractures in patients older than 60 years continues to be associated with a high complication rate [J].