ArticleJoint diseases and related surgery2023
The medial cortical ratio as a risk factor for failure after surgical fixation of proximal humerus fractures in elderly patients.
Article in Joint diseases and related surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison between CFR-PEEK and titanium plate for proximal humeral fracture: A meta-analysis.Joint diseases and related surgery · 2024Pooled it
- Evaluating the outcomes of PHILOS with allogeneic fibular support for treating Neer type III and IV proximal humeral fractures with associated glenohumeral dislocation in elderly patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Blood transfusion trends and risk factors in primary and revision shoulder arthroplasty: a single centre analysis.International orthopaedics · 2025Article
- Clinical and radiographic outcome of open reduction and internal fixation of 3- and 4-part proximal humerus fractures augmented with impaction bone grafting and a magnesium-based bone filler.JSES international · 2025Article
- Factors influencing shoulder stiffness after open reduction and internal fixation of proximal humeral fractures.Joint diseases and related surgery · 2024Article
- The Arterial Axis Lesions in Proximal Humeral Fractures-Case Report and Literature Review.Journal of personalized medicine · 2023Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to investigate whether the medial cortical ratio (MCR) is associated with fixation failure in patients undergoing plate-screw fixation due to proximal humeral fracture. PATIENTS AND
methodsBetween May 2011 and October 2020, a total of 93 patients (25 males, 68 females; mean age: 74.2±5.3 years; range, 65 to 92 years) who were operated for a proximal humeral fracture were retrospectively analyzed. The patients were divided into two groups during follow-up: patients with fixation failure (n=18) and patients with intact fixation (n=75). After radiological analysis, the MCR and fracture type were recorded. The effects of MCR and fracture type on the development of failure were evaluated.
resultsThe mean follow-up was 41.3±4.7 (range, 18 to 66) months. There was no significant correlation between fixation failure and MCR in either group (p=0.535). However, the risk of fixation failure increased by seven-fold in patients with MCR greater than 0.09 compared to the other patients. In addition, the fracture type was significantly more severe in the failed fixation group than the intact fixation group (p<0.001).
conclusionSurgical treatment of proximal humeral fractures in elderly patients still remains a challenge for surgeons due to the high failure rate. In elderly patients scheduled for surgery to treat a proximal humerus fracture, a reverse shoulder arthroplasty may be a reasonable choice to avoid reoperation due to fixation failure in elderly with three-part or more fragmented fractures and high MCR.
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