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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2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08917-0 |
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| author | Ryogo Furuhata Atsushi Tanji Yusaku Kamata Noboru Matsumura |
| author_facet | Ryogo Furuhata Atsushi Tanji Yusaku Kamata Noboru Matsumura |
| author_sort | Ryogo Furuhata |
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| description | 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. |
| format | Article |
| id | doaj-art-eeef961931df4bbf94d157fab6ffc627 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-eeef961931df4bbf94d157fab6ffc6272025-08-20T03:42:37ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-012611910.1186/s12891-025-08917-0Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fracturesRyogo Furuhata0Atsushi Tanji1Yusaku Kamata2Noboru Matsumura3Department of Orthopaedic Surgery, Ashikaga Red Cross HospitalDepartment of Orthopaedic Surgery, Ashikaga Red Cross HospitalDepartment of Orthopaedic Surgery, National Hospital Organization Tokyo Medical CenterDepartment of Orthopaedic Surgery, Keio University School of MedicineAbstract 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.https://doi.org/10.1186/s12891-025-08917-0Proximal humeral fracturePlate fixationOutcomePegGreater tuberosity reduction loss |
| spellingShingle | Ryogo Furuhata Atsushi Tanji Yusaku Kamata Noboru Matsumura Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures BMC Musculoskeletal Disorders Proximal humeral fracture Plate fixation Outcome Peg Greater tuberosity reduction loss |
| title | Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| title_full | Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| title_fullStr | Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| title_full_unstemmed | Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| title_short | Comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| title_sort | comparison of surgical outcomes of osteosynthesis using anatomical locking plates with proximal screws and smooth pegs for proximal humeral fractures |
| topic | Proximal humeral fracture Plate fixation Outcome Peg Greater tuberosity reduction loss |
| url | https://doi.org/10.1186/s12891-025-08917-0 |
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