78 - Freie Mitteilung
16. Mai 2019, 17:30 - 19:00, Sopra 3, 4. OG
Functional outcome after open or minimally invasive plate osteosynthesis of proximal humeral fracture-dislocations; A reduction technique and case control study
S. Haupt, H. Frima, C. Sommer, Presenter: S. Haupt (Chur)
Proximal humeral fracture-dislocations (PHFD) are a special entity in proximal humeral fracture treatment. The aim of this study is to present our minimally invasive plate osteosynthesis (MIPO) technique through an anterolateral deltoid-split approach. In addition, we performed a retrospective case control study analyzing the functional outcome and complications after PHFD.
A single center case control study was performed. All patients operated on for a PHFD between 2008 and 2016 were eligible for inclusion. The primary endpoint was the QuickDASH score. Secondary endpoints were the subjective shoulder value (SSV), complications and implant-related irritation.
Thirty-eight patients were included. Ten patients were operated on with a deltopectoral approach and 28 patients with MIPO. The mean age was 50 (SD ± 10.1). The median follow-up was 57 months (IQR 32 – 80). The mean QuickDASH score was 7.9 (SD ±12.0) and the mean SSV was 84 (SD ±18.2). There was no difference in functional outcome between both approaches (p=0.757 for QuickDASH and 1.000 for SSV). Seven patients had a conversion into a reversed arthroplasty (18%), two patients (5%) a shortening of secondary perforated screws, four patients an early re-osteosynthesis (11%), seven patients (18%) developed an AVN and in two patients damage of the axillary nerve was observed. Twenty-eight patients (73%) required implant removal.
Functional results after humeral head preservation and internal fixation of PHFD are promising after both the MIPO and deltopectoral approach. However, there is a high rate of re-operations either because of complications or for implant removal.