Post-Operative Greater Tuberosity Resorption or Malreduction Is Associated with Poor Prognostic Outcomes in Patients with Proximal Humeral Fractures Treated Operatively—A Single-Center Retrospective Cohort Study

Author:

Lu Kuan-Yu1ORCID,Tai Ting-Han1,Liu Yu-Hsin1,Chiang Chang-Jung12ORCID,Loh El-Wui3456,Wong Chin-Chean1278ORCID,Wu Jeffrey J.1

Affiliation:

1. Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

2. Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

3. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

4. Center for Evidence-Based Health Care, Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

5. Cochrane Taiwan, Taipei Medical University, Taipei 11031, Taiwan

6. Department of Medical Imaging, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

7. International PhD Program for Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

8. Research Center of Biomedical Devices, Taipei Medical University, Taipei 11031, Taiwan

Abstract

(1) Background: Proximal humerus fractures can be a debilitating condition if not properly treated. These fracture patterns are varied and differ in every patient. Functional outcomes may be determined by the integrity of the shoulder girdle involving the rotator cuff insertion. The post-operative resorption or malreduction of the greater tuberosity (GT) is an important factor contributing to the poor functional outcome of a patient. Thus, we intend to evaluate the cause-and-effect relationship between GT complications and clinical prognosis and outcomes. (2) Methods: A single-center retrospective comparative study was performed to evaluate the functional outcomes of patients undergoing operative fixation for this injury. A total of 387 consecutive cases treated operatively from 2019–2021 were included for analysis. (3) Results: 94 cases fulfilled our criteria for analysis. A matched-group comparison of 19 patients each was performed to compare demographics, post-operative fracture characteristics and clinical outcomes. (4) Conclusions: The resorption or malreduction of the GT contributes greatly to the prognostic outcome in patients treated with open reduction and internal fixation (ORIF) surgery. In our demographic study, obesity is another contributing factor affecting the parameters of post-operative reduction in proximal humerus fractures. Appropriate surgical planning and post-operative multidisciplinary care must be taken into consideration to attain a satisfactory prognostic outcome.

Funder

Taipei Medical University Shuang Ho Hospital

Publisher

MDPI AG

Subject

Clinical Biochemistry

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5. Tornetta, P. (2020). Rockwood and Green’s Fractures in Adults, Wolters Kluwer. [9th ed.].

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