Abstract
Background: Plating is commonly used in surgical fixation of mid-shaft humeral fractures. The literature lacks detail regarding plating complications or screw-plate fixation factors that may impact upon plating outcomes. This study aims to evaluate the outcomes of humeral shaft fractures treated by plating in two major trauma centres and to examine screw-plate fixation factors that may impact upon clinical outcome.
Materials and methods: Patients enrolled in the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) between 2003 and 2008 were identified. X-rays were reviewed independently by three orthopaedic surgeons to determine radiological union and fixation. Screw-plate implant details and post-operative clinical outcomes including loss of fixation and re-operation rate were evaluated. Health-related quality of life measures (SF-12) were assessed at 6 and 12-months post-injury.
Results: 103 patients (male n=72, female n=31; mean age 36.9 years) were identified. There were 25 complications in 22 patients with loss of fixation (n=7), superficial infection (n=5), deep infection (n=4) and non-union (n=4) being the most common. 13 patients required further surgical interventions. Screw placements on both sides of the fracture were evaluated; when at least 4 screws were placed on both sides of the fracture, there was no loss of fixation (p= 0.04). Median time to union was 22 weeks. At 12 months post injury, SF-12 scores were significantly below population norms.
Conclusions: There was a high incidence of post-operative complications following plating of humeral shaft fractures in this multi-trauma patient population. Our results indicate reduced rates of loss of fixation for having ≥4 screws on both sides of the fracture.
Materials and methods: Patients enrolled in the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) between 2003 and 2008 were identified. X-rays were reviewed independently by three orthopaedic surgeons to determine radiological union and fixation. Screw-plate implant details and post-operative clinical outcomes including loss of fixation and re-operation rate were evaluated. Health-related quality of life measures (SF-12) were assessed at 6 and 12-months post-injury.
Results: 103 patients (male n=72, female n=31; mean age 36.9 years) were identified. There were 25 complications in 22 patients with loss of fixation (n=7), superficial infection (n=5), deep infection (n=4) and non-union (n=4) being the most common. 13 patients required further surgical interventions. Screw placements on both sides of the fracture were evaluated; when at least 4 screws were placed on both sides of the fracture, there was no loss of fixation (p= 0.04). Median time to union was 22 weeks. At 12 months post injury, SF-12 scores were significantly below population norms.
Conclusions: There was a high incidence of post-operative complications following plating of humeral shaft fractures in this multi-trauma patient population. Our results indicate reduced rates of loss of fixation for having ≥4 screws on both sides of the fracture.
| Original language | English |
|---|---|
| Article number | 967 |
| Number of pages | 6 |
| Journal | Research |
| Volume | 1 |
| DOIs | |
| Publication status | Published - 21 Jul 2014 |