scholarly journals Locking plate fixation versus hemiarthroplasty for complex proximal humeral fractures: An updated systematic review and meta-analysis

2021 ◽  
Author(s):  
Miao Ding ◽  
Xingchen Pang ◽  
Xugang Li ◽  
Xusheng Qiu
Keyword(s):  
Systematic Review ◽  
Locking Plate ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Complex Proximal Humeral Fractures

scholarly journals Locking Plate Fixation versus Hemiarthroplasty for Complex Proximal Humeral Fractures: an Updated Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xugang Li ◽  
Xusheng Qiu ◽  
Xiaoyang Qi
Keyword(s):  
Systematic Review ◽  
Locking Plate ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Constant Murley Score ◽  
Significant Difference ◽  
Complex Proximal Humeral Fractures

Abstract BackgroundThis updated systematic review and meta-analysis was performed to compare clinical efficacy and safety of locking plate fixation (LPF) and hemiarthroplasty (HAP) for surgical treatment of complex proximal humeral fractures (PHFs).MethodsFive electronic databases (PubMed, EMBASE, CNKI, Wanfang database and the Cochrane Library) were searched from their start dates to July 2020 to identify all relevant studies. Our main endpoints were Constant–Murley score (efficacy), and method-related complications and revisions (safety). Cochrane Collaboration’s RevMan 5.3 was used for meta-analysis.ResultsSixteen retrospective trials and one randomized controlled trial involving a total of 936 patients (506 patients in the LPF group and 430 patients in the HAP group) were included in this analysis. The Constant–Murley score was significantly higher with LPF than with HAP [SMD=0.73, 95%CI: (0.23, 1.22)]. In subgroup analysis however, there was no significant difference in Constant-Murley score between LPF and HAP for four-part fractures [SMD=0.35, 95%CI (-0.07, 0.77)] or for subjects over 60 years of age [SMD=0.54, 95%CI: (-0.45, 1.52)]. Revision rate [OR=3.61, 95%CI (1.99, 6.56)] and postoperative complications [OR=1.80, 95%CI (1.24, 2.61)] were significantly lower with HAP than with LPF.ConclusionsIn general, for treatment of complex PHFs, LPF was superior to HAP in postoperative shoulder joint function assessed by the Constant–Murley score. However, there was no significant difference in efficacy for patients with four-part fractures or those older than 60 years of age. Since LPF was associated with significantly higher revision and postoperative complications rates, we suggest that HAP should be considered the preferred procedure for patients older than 60 years with four-part proximal humeral fractures.

Functional Outcomes Following Locking Plate Fixation of Complex Proximal Humeral Fractures

Orthopedics ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. e715-e722 ◽  
Author(s):  
Tingjun Ye ◽  
Lei Wang ◽  
Chengyu Zhuang ◽  
Yazi Wang ◽  
Weibin Zhang ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Complex Proximal Humeral Fractures

Locking plate fixation of proximal humeral fractures with impaction of the fracture site to restore medial column support: a biomechanical study

2013 ◽  
Vol 22 (11) ◽  
pp. 1552-1557 ◽  
Author(s):  
Colleen A. Weeks ◽  
Farhana Begum ◽  
Lauren A. Beaupre ◽  
Jason P. Carey ◽  
Samer Adeeb ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Fracture Site ◽  
Biomechanical Study ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation

Locking plate fixation for proximal humeral fractures: Initial results with a new implant

2007 ◽  
Vol 16 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Peter S. Rose ◽  
Christopher R. Adams ◽  
Michael E. Torchia ◽  
David J. Jacofsky ◽  
George G. Haidukewych ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Initial Results

scholarly journals Comparison of Intramedullary Nail Versus Locking Plate Fixation for Proximal Humeral Fractures

2009 ◽  
Vol 58 (4) ◽  
pp. 604-608 ◽  
Author(s):  
Katsuhiko Ishibashi ◽  
Gentaro Hanaishi ◽  
Kenichiro Nakai ◽  
Masato Nagashima ◽  
Hiroaki Tanaka
Keyword(s):  
Intramedullary Nail ◽  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation

Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures

2015 ◽  
Vol 24 (12) ◽  
pp. 1968-1973 ◽  
Author(s):  
Benedikt Schliemann ◽  
Robert Seifert ◽  
Steffen B. Rosslenbroich ◽  
Christina Theisen ◽  
Dirk Wähnert ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Biomechanical Study ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Bone Implant ◽  
Screw Augmentation

scholarly journals Fibular strut allograft influences reduction and outcome after locking plate fixation of comminuted proximal humeral fractures in elderly patients: a retrospective study

2019 ◽  
Author(s):  
Xueliang Cui ◽  
Hui chen ◽  
Binbin Ma ◽  
Wenbin Fan ◽  
He Li
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plate Fixation ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Head Height ◽  
Fibular Strut ◽  
Fibular Strut Allograft

Abstract Purpose: The purpose of this study was to determine if fibular strut allograft influence reduction and clinical outcomes after locking plate fixation of comminuted proximal humeral fractures (PHFs). Methods: A retrospective review was performed on sixty 3- and 4-part PHFs treated with either locking plate only or locking plate with a fibular allograft. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). Loss of anatomic fixation was defined if the varus malalignment of neck-shaft angle (NSA) was more than 5°or if the change of humeral head height (HHH) was more than 3 mm. Clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result: The average radiological changes were higher in the locking compression plate (LCP) group than in the locking plate with fibular allograft (FA) group ( HHH of 4.16mm versus 1.18mm [p﹤0.001] and NSA of 9.94° versus 3.12° [p﹤0.001 ]). Final average outcome scores were lower in LCP group than in FA group ( CMS of 73.00 versus 78.96 [p = 0.024] and ASES score of 72.80 versus 78.64 [p = 0.022]). FA group showed better forward elevation (P=0.010) and abduction (P=0.002), but no significant differences were observed for shoulder external rotation or internal rotation. Conclusion: For comminuted proximal humerus fractures in elderly patients with severe osteoporosis, locking plate fixation with a fibular strut allograft showed satisfactory radiological and clinical outcomes. Key words: proximal humeral fractures; locking compression plate; fibular allograft

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