Inadequate proximal screw fixation increases risk of failure following plate fixation of diaphyseal humerus fractures

Autor: Manisha R. Mistry, Jimmy Tat, Rafi Husain, Ujash Sheth, Robin R. Richards, Diane Nam
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Orthopaedic Surgery and Research, Vol 18, Iss 1, Pp 1-7 (2023)
Druh dokumentu: article
ISSN: 1749-799X
DOI: 10.1186/s13018-023-03566-2
Popis: Abstract Background Operative treatment of humeral shaft fractures (AO/OTA 12) is being performed more frequently. Accordingly, it is important to understand the complications associated with plate fixation. This study analyzes risk factors associated with mechanical failure following plate fixation of humeral shaft fractures in order to further elucidate the mode and location of failure. Methods A retrospective review of 351 humeral shaft fractures was completed at a single level I trauma center. Eleven of eighty-five humeral shaft fractures had aseptic mechanical failure requiring revision (12.9%), following initial plate fixation. Fracture characteristics (AO type, comminution, location) and fracture fixation (plate type, multiplanar, number of screws proximal and distal to the fracture) were compared between aseptic mechanical failure and those without failure. A forward stepwise logistic regression analysis was performed to determine any significant predictors of aseptic mechanical failure. Results There was significant differences in fixation between the aseptic mechanical failure group and those without failure, specifically in the number of screws for proximal fixation (p = 0.008) and distal fixation (p = 0.040). In the aseptic mechanical failure group, patients tended to have less than 8 cortices in both the proximal (62%) and distal fixation (70%). A forward stepwise logistic regression analysis found that less than
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