Outcome Analysis Following Removal of Locking Plate Fixation of the Proximal Humerus

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2008 Oct 14

PMID 18847508

Citations 27

Authors

Chlodwig Kirchhoff

Volker Braunstein

Sonja Kirchhoff

Christoph M Sprecher

Ben Ockert

Florian Fischer

Bernd A Leidel

Peter Biberthaler

Affiliations

Soon will be listed here.

Abstract

Background: Concerning surgical management experience with locking plates for proximal humeral fractures has been described with promising results. Though, distinct hardware related complaints after fracture union are reported. Information concerning the outcome after removal of hardware from the proximal humerus is lacking and most studies on hardware removal are focused on the lower extremity. Therefore the aim of this study was to analyze the functional short-term outcome following removal of locking plate fixation of the proximal humerus.

Methods: Patients undergoing removal of a locking plate of the proximal humerus were prospectively followed. Patients were subdivided into the following groups: Group HI: symptoms of hardware related subacromial impingement, Group RD: persisting rotation deficit, Group RQ: patients with request for a hardware removal. The clinical (Constant-Murley score) and radiologic (AP and axial view) follow-up took place three and six months after the operation. To evaluate subjective results, the Medical Outcomes Study Short Form-36 (SF-36), was completed.

Results: 59 patients were included. The mean length of time with the hardware in place was 15.2 +/- 3.81 months. The mean of the adjusted overall Constant score before hardware removal was 66.2 +/- 25.2% and increased significantly to 73.1 +/- 22.5% after 3 months; and to 84.3 +/- 20.6% after 6 months (p < 0.001). The mean of preoperative pain on the VAS-scale before hardware removal was 5.2 +/- 2.9, after 6 months pain in all groups decreased significantly (p < 0.001). The SF-36 physical component score revealed a significant overall improvement in both genders (p < 0.001) at six months.

Conclusion: A significant improvement of clinical outcome following removal was found. However, a general recommendation for hardware removal is not justified, as the risk of an anew surgical and anesthetic procedure with all possible complications has to be carefully taken into account. However, for patients with distinct symptoms it might be justified.

Citing Articles

Patient satisfaction after removal of locking plates in proximal humeral fractures - worth the surgery under functional and cosmetic aspects?.

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Intraoperative Doppler flowmetry evaluation of humeral head perfusion after proximal humerus fracture.

Akgun D, Paksoy A, Imiolczyk J, Bahlawane S, Gebauer H, Dey Hazra R JSES Int. 2024; 8(5):990-994.

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Comparison between CFR-PEEK and titanium plate for proximal humeral fracture: A meta-analysis.

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Katayama H, Nakashima H, Takahara Y, Itani S, Iwasaki Y, Kato H Arch Orthop Trauma Surg. 2023; 144(1):73-79.

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Is Elective Implant Removal after Fracture Healing Beneficial? - A Prospective Cohort Study.

Yuan W, Chua T, Kwek E Malays Orthop J. 2023; 16(3):55-60.

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