López CRE, Pérez AJM, Knierzinger D, Kralinger F

Language: Spanish
References: 18
Page: 80-87
PDF size: 142.31 Kb.

ABSTRACT

Introduction: The proximal humerus fracture (PHF) is the third most frequent fragility fracture. Nail fixation is one of the best treatment options for this type of fracture. In the older adult there are several factors that intervene in the result: those of the patient, the personality of the fracture and the surgical technique. Our goal is to analyze these risk factors which can predict the failure of our osteosynthesis. Material and methods: In this retrospective study of cases and controls of consecutive cases of patients older than 60 years with PHF of two Neer fragments, treated with fixation with centromedular nail (Multilock) straight, we analyzed by Odds Ratio eight of the factors that can help us predict complications in the treatment of these fractures. Results: Risk factors inherent to the patient such as advanced age and low bone density of the proximal humerus did not influence the incidence of complications, as they are factors present in our entire population. The factors that most influenced the incidence of complications were those inherent to the surgeon: reduction with absence of varus, the point of entry of the nail, fixation of the nail in its 5th anchorage point «proximal anchoring point» and the axial alignment of the fracture. Conclusion: In the older adult with fracture due to fragility of the proximal humerus treated with centromedullary nail Multilock, the surgeon’s action, an adequate reduction and surgical technique are the key to successful osteosynthesis and fewer complications.

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