ANALYSIS OF POSTOPERATIVE COMPLICATIONS IN THE SURGICAL TREATMENT OF PROXIMAL HUMERAL FRACTURES IN PATIENTS WITH DECREASED MINERAL BONE DENSITY

Authors

  • Vasyl Makarov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv; Municipal non-profit enterprise «City Clinical Hospital № 16» of the Dnipro City Council. Ukraine, Ukraine https://orcid.org/0000-0003-0936-7039
  • Mykola Korzh Municipal non-profit enterprise «City Clinical Hospital № 16» of the Dnipro City Council. Ukraine, Ukraine https://orcid.org/0000-0002-0489-3104

DOI:

https://doi.org/10.15674/0030-59872025137-44

Keywords:

Proximal humerus fracture, reverse total shoulder arthroplasty, RTSA, complications, Constant-Murley Score, reduced bone mineral density, functional assessment

Abstract

Objective. To conduct a comparative retrospective analysis of the impact of postoperative complications on functional outcomes following different surgical treatment methods for proximal humeral fractures of AO/OTA types 11-B and 11-C in patients over 45 years old with decreased bone mineral density. Methods. The study analyzed the surgical treatment outcomes and postoperative complications in 102 patients aged (61.1 ± 8.1) years, who were divided into three groups based on the treatment method: (1) open reduction and internal fixation (ORIF) using a PHILOS plate (n = 50); (2) ORIF with a PHILOS plate combined with 3D-printed PLA implants (n = 44); (3) primary reverse total shoulder arthroplasty (RTSA) using a newly developed total reverse endoprosthesis (n = 8). Functional outcomes in patients with complications were assessed using the Constant-Murley Score at 3, 6, and 12 months postoperatively and analyzed based on individual preoperative parameters and treatment methods. Results. A total of 30 postoperative complications were recorded, the most common being superficial infection (7.8 % of the total population), secondary displacement (6.9 %), varus malalignment of fragments (6.9 %), and avascular necrosis of the humeral head (3.9 %). The highest number of complications was observed in Group (1), with 19 patients affected, accounting for 38 % . For all complications except avascular necrosis, a significant improvement in functional outcomes was observed between 3 and 12 months postoperatively. The mean Constant-Murley Score in patients with complications at 12 months postoperatively was (78.7 ± 8.5). Conclusions A retrospective analysis of postoperative complications following different surgical treatment methods established that, compared to other options, reverse total shoulder arthroplasty (RTSA) is a modern and optimal surgical treatment option for proximal humeral fractures of AO/OTA types 11-B or 11-C in the context of severe bone mineral density reduction, particularly in elderly patients.

Author Biographies

Vasyl Makarov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv; Municipal non-profit enterprise «City Clinical Hospital № 16» of the Dnipro City Council. Ukraine

MD, DMSci, PhD in Orthopaedics and Traumatology

Mykola Korzh, Municipal non-profit enterprise «City Clinical Hospital № 16» of the Dnipro City Council. Ukraine

MD, Prof. in Traumatology and Orthopaedics

How to Cite

Makarov, V. ., & Korzh, M. . (2025). ANALYSIS OF POSTOPERATIVE COMPLICATIONS IN THE SURGICAL TREATMENT OF PROXIMAL HUMERAL FRACTURES IN PATIENTS WITH DECREASED MINERAL BONE DENSITY. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 37–44. https://doi.org/10.15674/0030-59872025137-44

Issue

Section

ORIGINAL ARTICLES