Comparison of the varus displacement effect of calcar screw in proximal humerus fractures

The aim of this study is to investigate whether not using the calcar screw in proximal humerus fractures affects functional and radiological outcomes. Thirty patients (21 females and 9 males) who presented with proximal humerus fractures and were treated with plate- screw fixation were evaluated. The patients were divided into two groups: group 1 included patients with the use of the calcar screw, and group 2 included patients without the calcar screw. Radiological evaluation was performed by measuring the neck-shaft angle on postoperative day 1 and at 1 year in true anteroposterior radiographs. The groups were compared regarding demographic characteristics, functional outcomes, radiological scores, and complications. The mean age was 60 (27-92) years. In group 1, a mean decrease of 5.2° in the neck-shaft angle was observed (136.1° on postoperative day 1 and 130.6° at 1 year; p<0.05). In group 2, a mean decrease of 3.1° was observed (133.5° on postoperative day 1 and 130.0° at 1 year; p>0.05). There was no significant difference in the change of the humerus neck- shaft angle between the two groups (p>0.05). The mean Constant score was 70.8 in group 1 and 76.7 in group 2, (p>0.05). There was no significant difference in varus displacement and functional outcomes between the groups using and not using the calcar screw in proximal humerus fractures. Good reduction, stable fixation with locking plates, and preservation of soft tissue integrity are crucial to avoid complications and promote healing in proximal humerus fractures.