Osteoporosis is a risk factor for locking-plate implant failure of proximal humerus fractures

Journal: Osteologie
ISSN: 1019-1291


Issue: Issues of 2014 (Vol. 23): Issue 1 2014 (1-72)
Pages: 16-21

Osteoporosis is a risk factor for locking-plate implant failure of proximal humerus fractures

F. Haasters (1), J. Kindsvater (1), G. Siebenbürger (1), W. Mutschler (1), B. Ockert (1)

(1) Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie, Klinikum der Universität München (LMU), München


Osteoporosis, Locking plate fixation, Proximal humeral fractures


Objectives: Locking plate fixation for the treatment of unstable proximal humeral fractures in the elderly is widely accepted. Within this patient group osteoporosis is a common co-morbidity. Therefore, the present study aimed to evaluate the influence of osteoporosis on failure of locking plate fixation and on fracture pattern. Methods: Women > 50 and men > 60 years with proximal humeral fracture and locking plate fixation were prospectively included over eight years with a follow up of two years. Bone mineral density measurement (DXA) was performed for all patients during in-patient hospital treatment. Results: Out of 167 patients 65,9 % were diagnosed with osteoporosis according to the WHO guidelines. Patients with osteoporosis showed a significantly higher rate of revision surgery (19,1 % vs. 7,0 %). Furthermore, osteoporosis was associated with a significantly higher incidence of AO 11-B2 and C2 fractures. These fracture entities showed a significantly higher rate of loss of fixation in osteoporotic patients. Discussion: In conclusion, patients with osteoporosis feature a significantly increased risk for complications and revision surgery after locking plate fixation of proximal humeral fractures. In addition to biomechanical limitations due to low bone mineral density, a different fracture pattern with focus on varus dislocation might contribute to a higher failure rate.

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