Influence of Local Bone Density on the Functional Outcome of Proximal Humerus Fractures Treated with Proximal Humerus...

Proximal humerus fractures (PHFs) constitute a majority of the most common osteoporotic fractures. Osteoporosis can complicate the surgical fixation and healing of PHFs and should be evaluated preoperatively. Bone density measurements can affect the treatment methods and outcomes. This study aimed to investigate the effect of osteoporosis using bone mineralization indices assessed from plain radiographs on functional outcomes.

Thirty-five patients who presented to our tertiary care center with PHFs between 2018 and 2021 were retrospectively evaluated among patients with optimal postoperative reduction. The age, gender of patients, and fracture types were evaluated according to Neer's classification from direct radiographs obtained at the time of admission were recorded. Tingart cortical thickness and Deltoid tuberosity index (DTI) measured from the radiographs were used to assess the status of osteoporosis status in all patients. Patients who had optimal postoperative reductions were followed up for radiological and functional assessments, and their correlations with osteoporosis measurements were examined.

According to the demographic characteristics of the patients, 20 patients were male, and 15 were female, and the mean age was 58.94 ± 14.4. Considering bone quality parameters in all patients, the mean Tingart value was 5.77, and the DTI was 1.62. Functional outcomes were assessed using the University of California at Los Angeles, CONSTANT, and disabilities of arm, shoulder, and hand scores. A statistically significant relationship and correlation existed between the osteoporosis parameters and the functional outcomes. In all the operated cases (n = 35), five patients (14.28%) had postoperative complications which were associated with osteoporotic parameters.

This study concluded that osteoporosis parameters are a simple and cost-effective parameter to assess preoperatively, as osteoporosis proved to be a main factor affecting postoperative functional outcomes. This manner of osteoporosis evaluation can be considered to change the plan of management to obtain better functional outcomes in osteoporotic individuals.