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Late screw-related complications in locking plating of proximal humerus fractures: A systematic review

Injury Nov 16, 2019

Panagiotopoulou VC, et al. - Researchers performed a systematic review in order to identify the potential risk factors for late screw complications related with locking plating, a common surgical treatment of proximal humeral fractures. Searching PubMed, they identified 100 studies meeting the inclusion criteria; 33% of the reported cases had at least one complication, with 11% of all complications being screw-related. Most of the latter were secondary screw perforations and screw cut-outs; these were predominantly linked to poor bone quality. Locking mechanism failure less frequently resulted in screw loosening and retraction. Overall, a limited amount of information for complications was gained. This indicates possibly underreporting and under-describing of the late screw complications. The most frequent screw-related complication reported was screw perforation, which was mostly reported in female patients older than 50 years, following four-part or AO/OTA type C fractures and detected 4 weeks postoperatively.
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