Dynamic-locking-screw (DLS)-leads to less secondary screw perforations in proximal humerus fractures.

Thomas Freude,Steffen Schroeter,Tobias M Kraus,Stefan Doebele,Ulrich Stoeckle,Christian Bahrs,Michael Plecko,Frank Martetschlaeger

doi:10.1186/1471-2474-15-194

Abstract

BackgroundLoss of reduction and screw perforation causes high failure rates in the treatment of proximal humerus fractures. The purpose of the present study was to evaluate the early postoperative complications using modern Dynamic Locking Screws (DLS 3.7) for plating of proximal humerus fractures.MethodsBetween 03/2009 and 12/2010, 64 patients with acute proximal humerus fractures were treated by angular stable plate fixation using DLSs in a limited multi-centre study. Follow-up examinations were performed three, six, twelve and twenty-four weeks postoperatively and any complications were carefully collected.Results56 of 64 patients were examined at the six-month follow-up. Complications were observed in 12 patients (22%). In five cases (9%), a perforation of the DLS 3.7 occurred.ConclusionsDespite the use of modern DLS 3.7, the early complications after plating of proximal humerus fractures remain high. The potential advantage of the DLS 3.7 regarding secondary screw perforation has to be confirmed by future randomized controlled trials.

Highlights

Loss of reduction and screw perforation causes high failure rates in the treatment of proximal humerus fractures
Proximal humerus fractures in elderly patients account for approximately 5% of all fractures and are mainly related to osteoporosis [1,2]
In order to improve the anchorage of screws especially in osteoporotic bone, angular stable proximal humerus

Summary

Introduction

Loss of reduction and screw perforation causes high failure rates in the treatment of proximal humerus fractures. The purpose of the present study was to evaluate the early postoperative complications using modern Dynamic Locking Screws (DLS 3.7) for plating of proximal humerus fractures. Techniques for osteosynthesis of proximal humerus fractures include closed or open reduction, and fixation with pins, plates, or intramedullary nails in previous studies, the clinical results have not shown to be very predictable [3,4,5,6,7,8]. USA) was developed to decrease the high rigidity of standard locked plate constructs. The new design of the DLS 3.7 offers the following advantages: 1. Compared to the Locking-Head-Screw 3.5(LHS 3.5), the DLS 3.7 has a blunt tip

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