Proximal humeral fracture morphology in patients with advanced cuff tear arthropathy: an observational study in a surgically treated cohort

Background In the presence of cuff tear arthropathy (CTA), joint kinematics is alternated and fracture configuration might be different. The purpose of this study was to identify fracture patterns in patients with advanced CTA to facilitate recognition and treatment. Methods Radiographs and computed...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2021-04, Vol.31 (3), p.517-524
Main Authors: Schmalzl, Jonas, Jessen, Malik, Gilbert, Fabian, Gerhardt, Christian, Lehmann, Lars-Johannes
Format: Article
Language:English
Subjects:
Classification
Confidence intervals
Fractures
Kinematics
Medical imaging
Medicine
Medicine & Public Health
Morphology
Observational studies
Original Article
Rotator cuff
Statistical analysis
Surgery
Surgical Orthopedics
Trauma
Traumatic Surgery
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Summary:Background In the presence of cuff tear arthropathy (CTA), joint kinematics is alternated and fracture configuration might be different. The purpose of this study was to identify fracture patterns in patients with advanced CTA to facilitate recognition and treatment. Methods Radiographs and computed tomography scans of all patients undergoing surgical treatment for a proximal humeral fracture (PHF) in our institution during a 5-year period were retrospectively analyzed. Fracture pattern according to the AO-OTA and Resch classification and the presence of CTA were evaluated. Glenoid configuration according to Walch, fatty atrophy of the supraspinatus muscle and the centrum–collum–diaphyseal (CCD) angle were analyzed. Results A total of 574 out of 713 patients were included. Twenty-three patients (4%) with a mean age of 82 ± 8 years showed advanced CTA with acetabularization of the acromion (≥ stage 3 according to Hamada/Fukuda). There were exclusively valgus fractures with a mean CCD angle of 158° ± 18°. Patients with CTA ≥ grade 3 had a nearly twofold greater risk (risk ratio: 1.8; confidence interval (CI): 95% 1.6–1.9; p  
ISSN:1633-8065
1432-1068
DOI:10.1007/s00590-020-02801-4