Universität zu Köln

Bockmann, Benjamin, Lechler, Philipp, Boese, Christoph Kolja, Aigner, Rene, Ruchholtz, Steffen and Frink, Michael (2019). Risk factors for secondary displacement in conservatively treated isolated greater tuberosity fractures: An analysis of 82 cases. Orthop. Traumatol.-Surg. Res., 105 (2). S. 317 - 323. PARIS: ELSEVIER MASSON, CORPORATION OFFICE. ISSN 1877-0568

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Abstract

Introduction: The optimal treatment of isolated fractures of the greater tuberosity is an important topic of current surgical research. While non-displaced fractures are amenable to conservative treatment, displacement of the fragment can result in rotator cuff malfunction and impingement. For the present study, risk factors predicting secondary fragment displacement were analyzed. Hypothesis: Certain risk factors determine a higher risk of secondary displacement in patients with greater tuberosity fractures. Patients and methods: All patients diagnosed with a fracture of the greater tuberosity and initially treated non-surgically at our Level I trauma center between January 2008 and July 2015 were included in this retrospective analysis. Patients were grouped into: no secondary displacement (group 1) and secondary displacement at follow-up (group 2). The following risk factors were analyzed: age, gender, side of fracture, initial displacement, fragment/head ratio, fragment shape, dislocation, concomitant fractures and concomitant fractures to the same extremity. Results: 82 patients (42 male, 40 female) were eligible for further analyses. Median follow-up was 8.0 +/- 39.5 days. Patients with secondary displacement (group 2) were significantly older (group 1: 51.7 +/- 15.5, group 2: 68.3 +/- 14.3; p < 0.001) and had significantly more shoulder dislocations (p = 0.024), whereas gender (p = 0.299), side of fracture (p = 0.189) and fragment/head ratio (p = 0.660) showed no significant different distribution between both groups. Finally, split-type fractures increased the risk of secondary displacement. Discussion: The present study identified age older than 65 years to be an important risk factor for secondary displacement in the conservative management of fractures of the greater tuberosity. Furthermore, fracture type and shoulder dislocations are factors associated with an increased relative risk for secondary displacement. (C) 2018 Published by Elsevier Masson SAS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bockmann, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Lechler, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Boese, Christoph Kolja UNSPECIFIED UNSPECIFIED UNSPECIFIED Aigner, Rene UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruchholtz, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Frink, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-152763
DOI:	10.1016/j.otsr.2018.06.017
Journal or Publication Title:	Orthop. Traumatol.-Surg. Res.
Volume:	105
Number:	2
Page Range:	S. 317 - 323
Date:	2019
Publisher:	ELSEVIER MASSON, CORPORATION OFFICE
Place of Publication:	PARIS
ISSN:	1877-0568
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROXIMAL HUMERUS; MECHANISM; INJURIES Multiple languages Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15276