Evidence map›Paper›PMID 35109905›Full record

ArticleJournal of orthopaedic surgery and research2022

Pegs not superior to screws for fixation of fractures of the proximal humerus.

Ingrid Bønes, Anna Cecilie Karlberg, Maria Liljeholm, Alexander Nilsskog Fraser, Jan Erik Madsen, Tore Fjalestad

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 33% 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.

NCT01737060 nacompletednot on this map

Clinical Investigation for Fractures of the Proximal Humerus in Elderly Patients. A Randomized Study of Two Surgical Treatments: Reverse Total Shoulder Arthroplasty Versus Angular Stable Device Philos

TypeinterventionalSponsorOslo University HospitalRan2013 to 2022Enrolled124ConditionsProximal Humeral Fractures, AO/OTA (2007) Group B2 and C2ArmsReverse total shoulder arthroplasty
NCT04622852 completednot on this map

Are Pegs Better Than Screw for Osteofixation of Proximal Humeral Fractures?

TypeobservationalSponsorOslo University HospitalRan2017 to 2021Enrolled38ConditionsImplant Complication, Proximal Humeral Fracture, Avascular Necrosis of HumerusArmsOpen reduction internal fixation (ORIF) with an angular stable plate
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
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

6 authors at 2 institutions in 1 country.

Ingrid BønesDivision of Orthopaedic Surgery (I.B., ML, J.E.M., T.F.), Oslo University Hospital, Postboks 4956, 0424, Nydalen, Oslo, Norway.
Anna Cecilie KarlbergDivision of Radiology and Nuclear Medicine, Department of Musculoskeletal Radiology (A.C.K.), Oslo University Hospital, Oslo, Norway.
Maria LiljeholmDivision of Orthopaedic Surgery (I.B., ML, J.E.M., T.F.), Oslo University Hospital, Postboks 4956, 0424, Nydalen, Oslo, Norway.
Alexander Nilsskog FraserOrthopaedic Department, Diakonhjemmet Hospital, Oslo, Norway.
Jan Erik MadsenDivision of Orthopaedic Surgery (I.B., ML, J.E.M., T.F.), Oslo University Hospital, Postboks 4956, 0424, Nydalen, Oslo, Norway.
Tore FjalestadDivision of Orthopaedic Surgery (I.B., ML, J.E.M., T.F.), Oslo University Hospital, Postboks 4956, 0424, Nydalen, Oslo, Norway. torfja@online.no.ORCID http://orcid.org/0000-0002-4995-9891
Oslo University Hospital · NODiakonhjemmet Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAngular stable plates were introduced two decades ago as a promising treatment for fixation of displaced fractures of the proximal humerus (PHF). However, high rates of adverse events and reoperations have been reported. One frequent reason is secondary penetration of screws into the glenohumeral joint, due to sinking of the fracture or avascular head necrosis. To prevent joint penetrations angular stable plates with smooth locking pegs instead of locking screws have been developed. The aim of the present study was to investigate whether blunt pegs instead of pointed screws reduced the risk of secondary penetration into the glenohumeral joint during fracture healing after operatively treated PHFs.

methodsFrom two different patient cohorts with displaced PHFs (60 treated with PHILOS plate with screws and 50 with ALPS-PHP plate with pegs), two groups were matched according to fracture type AO/OTA 11-B2 and 11-C2 and age (55-85 years). They were followed up at 3, 6 and 12 months. Primary outcome was radiographic signs of peg or screw penetrations into the glenohumeral joint at 12 months. Secondary outcomes were Oxford shoulder score (OSS) and Constant Score (CS) and radiographic signs of avascular humeral head necrosis (AVN).

resultsEighteen PHILOS patients with B2 and C2 fractures could be matched with a corresponding group of 18 operated with ALPS-PHP with pegs. The number of penetrations of pegs and screws were equal between the two groups and the development of avascular head necrosis did not differ either. The functional outcomes for both OSS and CS at 12 months was clearly in favor of patients without joint penetrations in both groups.

conclusionWe found no differences in the number of screw or peg penetrations in the PHILOS and ALPS-PHP group and the occurrence of AVN was equal. Joint penetrations led to inferior functional outcomes at 1 year. The ClinicalTrials.gov identifier 20/11/12 prospectively for the Philos Group is NCT01737060, and for the ALPS group 11/03/20 retrospectively is NCT04622852.

Indexed as

AgedAged, 80 and overBone PlatesBone ScrewsFracture Fixation, InternalHumansMiddle AgedNecrosisPostoperative ComplicationsRetrospective StudiesShoulderShoulder FracturesTreatment Outcome

Identifiers

PMID35109905
PMCPMC8812225
OpenAlexW4210711972

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.