ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2021
Complication rate after operative treatment of three- and four-part fractures of the proximal humerus: locking plate osteosynthesis versus proximal humeral nail.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Comparison between CFR-PEEK and titanium plate for proximal humeral fracture: A meta-analysis.Joint diseases and related surgery · 2024Pooled it
- Efficacy of PHILOS combined with n-HA/PA66 augmentation for treating three- or four-part proximal humeral fractures in elderly patients.Journal of orthopaedic surgery and research · 2025Article
- Functional and radiological outcomes of percutaneous wiring for two and three part fractures of the proximal humerus.Journal of clinical orthopaedics and trauma · 2025Article
- Comparative analysis of unicortical vs. subchondral locking screws in osteoporotic proximal humerus fractures.Heliyon · 2025Article
- Patient satisfaction after removal of locking plates in proximal humeral fractures - worth the surgery under functional and cosmetic aspects?JSES international · 2024Article
- Reverse Shoulder Prosthesis for Proximal Humeral Fractures: Primary Treatment vs. Salvage Procedure.Journal of clinical medicine · 2024Article
- Preventing secondary screw perforation following proximal humerus fracture after locking plate fixation: a new clinical prognostic risk stratification model.Archives of orthopaedic and trauma surgery · 2024Article
- Quality of life, functional and radiological outcomes of treatment of three-part and four-part proximal humerus fractures with locking plates and comparison in young versus older than 70 years: a retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Cement-Augmented Screw Fixation with PHILOS Plating for Osteoporotic Proximal Humeral Fractures: An Observation of Mid- and Long-Term Curative Efficacy.Orthopaedic surgery · 2023Article
- Effect of the Initial Deformity in the Coronal Plane on Postoperative Outcome of Proximal Humeral Fractures.Orthopaedic surgery · 2023Article
- Preventing varus collapse in proximal humerus fracture fixation: 90-90 dual plating versus endosteal fibular allograft strut.Archives of orthopaedic and trauma surgery · 2023Article
- Minimum 2-year results of the second-generation CFR-PEEK locking plate on the proximal humeral fracture.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- A Standardized Operative Protocol for Fixation of Proximal Humeral Fractures Using a Locking Plate to Minimize Surgery-Related Complications.Journal of clinical medicine · 2023Article
- Biomechanical evaluation of novel intra- and extramedullary assembly fixation for proximal humerus fractures in the elderly.Frontiers in bioengineering and biotechnology · 2023Article
- [Comparison of locking plate and intramedullary nail in treatment of Neer two- and three-part fractures of the proximal humerus in the elderly].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Age-Independent Clinical Outcome in Proximal Humeral Fractures: 2-Year Results Using the Example of a Precontoured Locking Plate.Journal of clinical medicine · 2022Article
- Three-part humeral head fractures treated with a definite construct of blocked threaded wires: finite element and parametric optimization analysis.JSES international · 2021Article
- Dynamic locking screws in proximal humeral plate osteosynthesis demonstrate superior fixation properties: a biomechanical study.Journal of experimental orthopaedics · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThere is still disagreement regarding the optimal surgical treatment of three- and four-part fractures of the proximal humerus. The aim of this monocentric, retrospective study was to compare the complication rate of internal fixation with a locking plate versus proximal humeral nailing after a one-year follow-up.
methodsFrom 2005 to 2016, 292 patients suffered a fracture of the proximal humerus and were treated surgically at our level-I trauma center. According to the inclusion criteria, 50 patients were included in this study: 19 of these (11 three-part fractures and 8 four-part fractures) were treated with a proximal humeral nail (HN) and 31 (12 three-part fractures and 19 four-part fractures) with a locking plate (LP) osteosynthesis. Classification was performed according to the Hertel classification. At a 1-year follow-up, the complication rate of the two treatment methods was compared.
resultsTwenty patients (40%) suffered at least one complication. Of these, six patients (12%) were treated with a HN and 14 (28%) with a LP (p = 0.39). The most frequent complication was screw perforation (22%), followed by non-union (16%). Humeral head necrosis (10%) occurred only in the LP cohort. One wound infection occurred in a patient treated with a HN. Four-part fractures were treated more frequently with a LP. However, the difference was non-significant in this sample (p = 0.186).
conclusionsThe results of our study provide some evidence that in terms of complication rate, both treatment options are comparable for internal fixation of three- and four-part fractures of the proximal humerus. The type of fracture seems to be decisive for the choice of implant.
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