Roberto Enrique Lopez-CervantesClinica de Fracturas por Fragilidad, Mexico
Title: Femoral head augmentation in 3–4-part proximal humerus fracture plating in the elderly population and its failure predictors
Bad bone quality and greater age are related to bad outcomes in proximal humerus fractures (PHF). In these patients, using augmentation helps us reduce the failure rate. The objective of this study was to evaluate the early complications and mechanical failures in 3 and 4-part treated with femoral head allograft augmentation plating vs plating alone. Methods: We included 30 patients above 65 years old, with 3-4-part PHF treated with Proximal Humeral Internal Locking System (Philos) (9 augmented patients and 21 non-augmented patients). We evaluated as complication risk factors: deltoid tuberosity index, age, fracture type, calcar extension, varus, head fragment size, the reduction quality and type of fracture, and time to surgery. Then we analyze the risk factors for complications, pain, and range of motion in both groups. Results: The average age was 78.1 years, 63% of and the patients had bad bone quality (DTI Less than 1.44). Of the risk factors, we demonstrate that greater age p = 0.03, absence of calcar reconstruction.05, and absence of augmentation p = 0.05 were 3 statistically significant risk factors for complications. Conclusion: In this study, we can conclude that osteosynthesis with plates must be reserved for selected patients of these ages due to the high incidence of complications. We confirm that with greater age, the greater the chance for failure. The use of allograft augmentation is a useful tool to use in these cases, but it doesn’t replace the anatomical reduction of the medial calcar
Roberto E. López-Cervantes is an Orthopedic surgeon who Graduated from Mexico City in 2017 from UNAM university. Since then, he has done a Fellow in Shoulder and Elbow surgery in Vienna, Austria, a Master’s in Bioethics, and a Certification in Clinical Densitometry. Is the author of 7 indexed papers, coauthor in other 6, now having 38 citations. He is working as an orthopedic and trauma surgeon and FLS coordinator in the City of Guadalajara, México, in the Osteoporotic Fracture Clinic at the Specialty Hospital San Francisco de Asis. He is currently the national coordinator of the fragility fracture and Osteoporosis committee in the Mexican Federation Colleges of Orthopedics and Trauma, Coordinator of the Mexican Hip Fracture National Audit, and General Secretary of the Mexican Association of Osteoporosis and Bone metabolic diseases.