Abstract
Background and Objectives: The aim of this study was to evaluate whether device removal in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture improves the clinical outcomes. Materials and Methods: Seventy-one patients who underwent fixed-angle locking plate osteosynthesis of a proximal humerus fracture were included. Thirty-three patients underwent device removal at a mean time of 10.4 months after index surgery (removal group). Thirty-eight patients who retained the device after index surgery (retention group) were included in the control group. Visual analog scale (VAS) pain score, University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were evaluated pre- and postoperatively. Results: At the final follow-up, mean UCLA score, ASES score, and all ROMs were significantly higher in the removal group compared to the retention group (p < 0.001). However, no significant difference in mean VAS pain score was observed between the two groups. Comparison of the clinical outcomes before and after device removal surgery showed significant improvement in all clinical scores and ROMs after device removal (p < 0.001). Conclusions: Device removal surgery in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture can result in significant improvement in functional outcomes.
Highlights
As we become an ageing society, the number of proximal humerus fractures is increasing [1]
The findings of this study showed that device removal surgery in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture can result in significant improvement in functional outcomes without complications
There are possible benefits of device removal surgery in patients after proximal humerus fractures are treated by open reduction and internal fixation (ORIF) with a locking plate
Summary
As we become an ageing society, the number of proximal humerus fractures is increasing [1]. Fixed-angle locking plate osteosynthesis for unstable proximal humerus fractures has recently become a well-established treatment option, and satisfactory clinical and radiographic outcomes were reported [2–7,10]. Postoperative clinical outcomes can be influenced by implant-related complications, such as pain or tissue irritation around the retained implant or impaired function [10,12–15]. In orthopedic practice, these implant-related problems are indications for implant removal after fracture union [16–19]. The aim of this study was to evaluate whether device removal in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture improves the clinical outcomes. Conclusions: Device removal surgery in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture can result in significant improvement in functional outcomes
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