Journal of orthopaedic trauma · 2026
Similar Outcomes in Proximal Humerus Fractures Treated With Conventus Intramedullary Cage Device and Open Reduction Internal Fixation.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Kurkowski Sarah C, Taleghani Eric R, McMillan Paul, Solomon Eric G, Keller Jonas E, Gerak Samuel K, Wyrick John D, Grawe Brian M
Аннотация
OBJECTIVES: To compare clinical outcomes between open reduction and internal fixation (ORIF) with or without Conventus intramedullary cage (CC) for proximal humerus fractures.
DESIGN: Retrospective cohort study.
SETTING: Level 1 trauma center.
PATIENT SELECTION CRITERIA: Included were patients who sustained OTA/AO 11B and 11C fractures treated with ORIF with or without CC with minimum 1 year follow-up.
OUTCOME MEASURES AND COMPARISONS: Primary outcomes included complication and reoperation rates. Secondary outcomes were American Shoulder and Elbow Surgeons and Short Form 12 (SF-12) scores. Outcomes were compared between fixation strategies.
RESULTS: Fifty-six patients were included, 33 ORIF and 23 CC, with mean follow-up of 5.0 (range 1.1-11.4) and 5.3 (range 2.3-7.6) years, respectively. The ORIF and CC groups were 27.3% and 21.7% men, respectively ( P = 0.759). The ORIF group had a higher mean age (68.2 ± 5.3 vs. 64.2 ± 8.7 years, P = 0.037). There was a higher proportion of OTA/AO 11C fractures in the CC cohort (65.2% vs. 33%, P = 0.029). CC group had a higher unplanned reoperation rate (18.2% vs. 34.8% for CC, P = 0.158) and complication rate (24.2% vs. 39.1% for CC, P = 0.233) that did not reach statistical significance within this available study population. Unplanned reoperations in the CC cohort included revision fixation (3) and conversion to hemiarthroplasty (2) or reverse total shoulder arthroplasty (3). There were no differences in American Shoulder and Elbow Surgeons scores (mean 65.3 for ORIF and 63.1 for CC, P = 0.773), physical SF-12 scores (mean 39.0 for ORIF and 42.1 for CC, P = 0.342), and mental SF-12 scores (mean 50.3 for ORIF and 52.4 for CC, P = 0.495) at final follow-up.
CONCLUSIONS: OTA/AO 11B and 11C proximal humerus fractures treated with Conventus intramedullary cage augmentation demonstrated a trend toward higher reoperation and complication rates than standard ORIF, although this difference did not reach statistical significance. Midterm patient-reported outcome scores were similar between cohorts, suggesting that Conventus intramedullary cage augmentation may not provide additional clinical benefit.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
DESIGN: Retrospective cohort study.
SETTING: Level 1 trauma center.
PATIENT SELECTION CRITERIA: Included were patients who sustained OTA/AO 11B and 11C fractures treated with ORIF with or without CC with minimum 1 year follow-up.
OUTCOME MEASURES AND COMPARISONS: Primary outcomes included complication and reoperation rates. Secondary outcomes were American Shoulder and Elbow Surgeons and Short Form 12 (SF-12) scores. Outcomes were compared between fixation strategies.
RESULTS: Fifty-six patients were included, 33 ORIF and 23 CC, with mean follow-up of 5.0 (range 1.1-11.4) and 5.3 (range 2.3-7.6) years, respectively. The ORIF and CC groups were 27.3% and 21.7% men, respectively ( P = 0.759). The ORIF group had a higher mean age (68.2 ± 5.3 vs. 64.2 ± 8.7 years, P = 0.037). There was a higher proportion of OTA/AO 11C fractures in the CC cohort (65.2% vs. 33%, P = 0.029). CC group had a higher unplanned reoperation rate (18.2% vs. 34.8% for CC, P = 0.158) and complication rate (24.2% vs. 39.1% for CC, P = 0.233) that did not reach statistical significance within this available study population. Unplanned reoperations in the CC cohort included revision fixation (3) and conversion to hemiarthroplasty (2) or reverse total shoulder arthroplasty (3). There were no differences in American Shoulder and Elbow Surgeons scores (mean 65.3 for ORIF and 63.1 for CC, P = 0.773), physical SF-12 scores (mean 39.0 for ORIF and 42.1 for CC, P = 0.342), and mental SF-12 scores (mean 50.3 for ORIF and 52.4 for CC, P = 0.495) at final follow-up.
CONCLUSIONS: OTA/AO 11B and 11C proximal humerus fractures treated with Conventus intramedullary cage augmentation demonstrated a trend toward higher reoperation and complication rates than standard ORIF, although this difference did not reach statistical significance. Midterm patient-reported outcome scores were similar between cohorts, suggesting that Conventus intramedullary cage augmentation may not provide additional clinical benefit.
LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.