Is Device Removal Necessary after Fixed-Angle Locking Plate Osteosynthesis of Proximal Humerus Fractures?

Abstract

Background and Objectives: The aim of this study was to evaluate whether device removal in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture improves the clinical outcomes.

Materials and Methods: Seventy-one patients who underwent fixed-angle locking plate osteosynthesis of a proximal humerus fracture were included. Thirty-three patients underwent device removal at a mean time of 10.4 months after index surgery (removal group). Thirty-eight patients who retained the device after index surgery (retention group) were included in the control group. Visual analog scale (VAS) pain score, University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) were evaluated pre- and postoperatively.

Results: At the final follow-up, mean UCLA score, ASES score, and all ROMs were significantly higher in the removal group compared to the retention group (p < 0.001). However, no significant difference in mean VAS pain score was observed between the two groups. Comparison of the clinical outcomes before and after device removal surgery showed significant improvement in all clinical scores and ROMs after device removal (p < 0.001).

Conclusions: Device removal surgery in symptomatic patients following locking plate osteosynthesis of a proximal humerus fracture can result in significant improvement in functional outcomes.