ArticleBMC musculoskeletal disorders2020
High rate of unexpected positive cultures in presumed aseptic revision of stiff shoulders after proximal humerus osteosynthesis.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Peri-implant soft tissue colonization after osteosynthesis in asymptomatic patients: a prospective study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Unexpected Positive Cultures After Failed Proximal Humerus Osteosynthesis: Why a Two-Stage Procedure Could Be Safer.Journal of clinical medicine · 2026Article
- Treatment of infected humeral shaft nonunion and presumed aseptic nonunion with positive intraoperative cultures: a retrospective single-center study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021.Scientific reports · 2023Article
- The value of sonication on orthopaedic implants in an everyday clinical setting - an exploratory study.BMC musculoskeletal disorders · 2023Article
- How to treat stiffness after proximal humeral fractures?EFORT open reviews · 2023Review
- [Management of fracture-related infections].Der Unfallchirurg · 2022Review
- [Posttraumatic shoulder stiffness].Der Unfallchirurg · 2021Article
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6 authors.
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Abstract
backgroundThe aim of this study was to investigate the prevalence of positive microbiology samples after osteosynthesis of proximal humerus fractures at the time of revision surgery and evaluate clinical characteristics of patients with positive culture results.
methodsAll patients, who underwent revision surgery after locked platting, medullary nailing or screw osteosynthesis of proximal humeral fractures between April 2013 and July 2018 were retrospectively evaluated. Patients with acute postoperative infections, those with apparent clinical signs of infection and those with ≤1 tissue or only sonication sample obtained at the time of implant removal were excluded. Positive culture results of revision surgery and its correlation with postoperative shoulder stiffness was analyzed in patients with an interval of ≥6 months between the index osteosynthesis and revision surgery.
resultsIntraoperatively obtained cultures were positive in 31 patients (50%). Cutibacterium acnes was the most commonly isolated microorganism, observed in 21 patients (67.7%), followed by coagulase negative staphylococci in 12 patients (38.7%). There were significantly more stiff patients in the culture positive group compared to the culture-negative group (19/21, 91% vs. 15/26, 58%, p = 0.02). Furthermore, 11 of 12 (91.7%) patients with growth of the same microorganism in at least two samples had a stiff shoulder compared to 23 of 35 (65.7%) patients with only one positive culture or negative culture results (p = 0.14).
conclusionInfection must always be considered as a possibility in the setting of revision surgery after proximal humerus osteosynthesis, especially in patients with postoperative stiffness.
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