Evidence map›Paper›PMID 30092807›Full record

ArticleJournal of orthopaedic surgery and research2018

Calcar screws and adequate reduction reduced the risk of fixation failure in proximal humeral fractures treated with a locking plate: 190 patients followed for a mean of 3 years.

Sjur Oppebøen, Annette K B Wikerøy, Hendrik F S Fuglesang, Filip C Dolatowski, Per-Henrik Randsborg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of orthopaedic surgery and research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 38 citations in OpenAlex.

  1. Trial
  2. [Research progress on medial support augmentation techniques for proximal humeral fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Review
  3. Article
  4. Surgeon-related Factors in the Surgical Treatment of Proximal Humerus Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024
    Article
  5. Article
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  11. [Current trends in reverse fracture arthroplasty].Unfallchirurgie (Heidelberg, Germany) · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Sjur OppebøenDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway. sjur_oppeboen@hotmail.com.ORCID http://orcid.org/0000-0003-0495-6811
Annette K B WikerøyDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Hendrik F S FuglesangDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Filip C DolatowskiDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Per-Henrik RandsborgDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Akershus University Hospital · NOUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFixation of proximal humeral fractures (PHF) with locking plates has gained popularity over conservative treatment, but surgery may be complicated with infection, non-union, avascular necrosis (AVN) of the humeral head and fixation failure. Failure to achieve structural support of the medial column has been suggested to be an important risk factor for fixation failure. The aims of this study were to examine the effect of calcar screws and fracture reduction on the risk of fixation failure and to assess long-term shoulder pain and function.

methodsThis was a single-centre retrospective study of 190 adult PHF patients treated with a locking plate between 2011 and 2014. Reoperations due to fixation failure were the primary outcome. Risk factors for fixation failure were assessed using the Cox regression analysis. Postoperative shoulder pain and function were assessed by the Oxford Shoulder Score (OSS).

resultsThirty-one of 190 (16%) patients underwent a reoperation: 14 (7%) due to fixation failure, 10 (5%) due to deep infection and 2 (1%) due to AVN. The absence of calcar screws and fixation with residual varus malalignment (head-shaft angle < 120°) both increased the risk of fixation failure with an adjusted hazard ratio (95% CI) of 8.6 (1.9-39.3; p = 0.005) and 4.9 (1.3-17.9; p = 0.02), respectively. The median (interquartile range) OSS was 40 (27-46).

conclusionThe use of calcar screws, as well as the absence of postoperative varus malalignment, significantly reduced the risk of fixation failure. We, therefore, recommend the use of calcar screws and to avoid residual varus malalignment to improve the medial support of proximal humeral fractures treated with a locking plate.

Indexed as

AgedAged, 80 and overArthralgiaBone PlatesBone ScrewsFemaleFollow-Up StudiesFracture Fixation, InternalHumansMiddle AgedRecovery of FunctionReoperationRetrospective StudiesRisk FactorsShoulder FracturesShoulder JointCalcar screwsFixation failureLocking plate fixationLong-term shoulder functionProximal humeral fractureReoperation

Identifiers

PMID30092807
PMCPMC6085712
OpenAlexW2887631947

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.