Assessing complications and functional outcomes in proximal humerus fracture management: a retrospective comparison between conservative and intramedullary nailing treatments

Assessing complications and functional outcomes in proximal humerus fracture management: a retrospective comparison between conservative and intramedullary nailing treatments

Introduction Fractures of the proximal end of the humerus (FPH) are the second most common fractures in the upper limb after fractures of the distal radius and are two to three times as common in women than in men. Therefore, the main objective of the present study was to compare and analyze the com...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology Vol. 34; no. 3; pp. 1427 - 1433
Main Authors: Czarnecki, Piotr, Falis, Mirosław, Bonczar, Michał, Ostrowski, Patryk, Wcisłek, Józef, Romanowski, Leszek
Format: Journal Article
Language:English
Published: Paris Springer Paris 01-04-2024
Springer Nature B.V
Subjects:
Bursitis
Cross-Sectional Studies
Female
Fracture Fixation, Internal - methods
Fracture Fixation, Intramedullary - adverse effects
Fracture Fixation, Intramedullary - methods
Fractures
Humans
Humeral Fractures - surgery
Humeral Head
Humerus
Male
Medicine
Medicine & Public Health
Necrosis
Original Article
Orthopedics
Patients
Retrospective Studies
Rotator cuff
Shoulder Fractures - surgery
Surgeons
Surgery
Surgical Orthopedics
Traumatic Surgery
Treatment Outcome
Fracture
Proximal end of the humerus
Humerus
Surgery
Orthopedics
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Summary:Introduction Fractures of the proximal end of the humerus (FPH) are the second most common fractures in the upper limb after fractures of the distal radius and are two to three times as common in women than in men. Therefore, the main objective of the present study was to compare and analyze the complications and the functional outcomes in patients with displaced FPH receiving conservative and surgical treatments with intramedullary nailing. Methods A retrospective cross-sectional study was conducted to establish the differences in complications risks between surgical and non-surgical treatment of the FPH. For this purpose, the clinical and radiological results of 67 consecutive patients were analyzed. Results A total of 25 patients were included in the non-surgically treated group. A total of 42 patients were included in the surgically treated group. Complications occurred in a total of 4 (16.0%) patients after the non-surgical treatment. Those included frozen shoulder ( n  = 2), nonunion ( n  = 1), and avascular necrosis of the humeral head ( n  = 1). Complications occurred in a total of 18 (42.6%) patients after the surgical treatment. Non-surgically treated patients had statistically significantly ( p  < 0.05) lower scores in the Constant-Murley scale in all of the categories. Conclusion The present study demonstrates an overall prevalence of complications to be 16% in patients treated conservatively and 42.6% in patients treated surgically. In the non-surgical cohort, the frozen shoulder was the most frequently observed complication (8%). Interestingly, non-anatomical repositioning was the most prevalent complication in surgically treated patients. Due to the complexity of the FPH, we believe that the surgeon needs to have comprehensive knowledge regarding the characteristics of this fracture, the available treatment options, and the possible complications that may occur. This can enhance patient safety and provide satisfactory clinical outcomes.
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ISSN:1432-1068
1633-8065
1432-1068
DOI:10.1007/s00590-023-03822-5