• Caio Zamboni, Guilherme Vieira Gonçalves, Luiz Henrique Gallego Conte, Pedro Gabriel Pelegrino do Val, José Octavio Soares Hungria, Ralph Walter Christian, and Marcelo Tomanik Mercadante.
• Assistant of the Trauma Surgery Group of Santa Casa de São Paulo, Brazil. Electronic address: caiozamboni@hotmail.com.
• Injury. 2021 Jul 1; 52 Suppl 3: S29-S32.

IntroductionFractures of the proximal humerus are frequent and are widely studied with regards to their treatment indications. The aim of this article is to establish a correlation between the size of the epiphyseal fragment in fractures of the proximal humerus and the probability of loss of reduction after a surgical procedure.MethodsA total of 47 surgically treated proximal humeral fractures were reviewed. Preoperative CT scans were used to evaluate the size of the epiphyseal fragment of the fracture. Postoperative X-rays were analyzed to assess complications, especially loss of reductions. Mean age was 61 years old (29-91 years).ResultsIn total, 42 shoulders were evaluated. The average size of the epiphyseal fragment was 38.3 mm (32-50 mm) the largest longitudinal length; and 19.9 mm (12-30 mm) the largest cross-sectional length. The most frequent complication observed was loss of reduction. The statistical analysis showed significance that patients with smaller cross-sectional size of the epiphyseal fragment presented more complications (p = 0.034), and based on the graph and ROC curve, a value of 15.5 mm was considered as the cutoff value for failure.ConclusionA cross-sectional length of the epiphyseal fragment of less than 15.5 mm indicates a higher probability of loss of reduction in fractures of the proximal end of the humerus after extra-medullary osteosynthesis.Copyright © 2021. Published by Elsevier Ltd.

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