Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures
Abstract Background Plate fixation is a widely used surgical procedure for proximal humeral fracture; however, relatively high complication rates have been reported. To prevent the occurrence of proximal screw cut out, pegs with blunt tips have been introduced to replace traditional screws for fixat...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-025-08917-0 |
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| Summary: | Abstract Background Plate fixation is a widely used surgical procedure for proximal humeral fracture; however, relatively high complication rates have been reported. To prevent the occurrence of proximal screw cut out, pegs with blunt tips have been introduced to replace traditional screws for fixation of the humeral head. However, few reports are available on the effect of using smooth pegs on surgical outcomes. In this study, we aimed to compare the postoperative outcomes of osteosynthesis using anatomical plates using all proximal screws and using all proximal pegs. Methods We retrospectively identified 48 patients who underwent osteosynthesis using an anatomical locking plate for proximal humeral fractures. We divided the patients into a screw group (25 patients) and a peg group (23 patients) according to the devices used to fix the humeral head. We compared operative outcomes, postoperative shoulder functional scores, and postoperative complication rates between the two groups. Results In terms of operative outcomes, the operation time was significantly shorter in the peg group than that in the screw group (94 [83–105] min vs. 114 [98–124] min, p < 0.001, r = 0.52). No significant differences in adjusted Constant score and American Shoulder and Elbow Surgeon score were observed at 1 year postoperatively between the two groups. However, the incidence of greater tuberosity reduction loss was significantly higher in the peg group than that in the screw group (17.4% vs. 0%, p = 0.046, φ = 0.32). Conclusions Our study showed that the use of proximal pegs did not significantly affect postoperative shoulder functional outcomes, although it may reduce operative time. In three-part fractures involving the greater tuberosity, the use of proximal screws or plates with sufficient coverage of the greater tuberosity may be desirable to prevent reduction loss of the greater tuberosity. |
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| ISSN: | 1471-2474 |