• Jan Dauwe, Gregory Walters, Eduard Van Eecke, Kris Vanhaecht, and Stefaan Nijs.
• Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium. dauwejan@gmail.com.
• Eur J Trauma Emerg Surg. 2021 Dec 1; 47 (6): 1889-1893.

PurposeProximal humeral fractures are the third most common fractures affecting the elderly. Angular stable osteosynthesis has become indispensable in the operative treatment. However, surgical fixation remains challenging. The aim of this retrospective study was to analyse the failure rate after osteosynthesis of proximal humeral fractures over a year in a level-1 trauma centre. Furthermore, parameters that are presumed to be related to osteosynthesis failure will be investigated and discussed.MethodsAfter meeting the exclusion criteria, 134 patients were operatively treated with angular stable osteosynthesis between January 2017 and January 2018 at the University Hospitals of Leuven.ResultsCirca 16% of the proximal humeral osteosyntheses failed. Our study showed that the most significant parameter for osteosynthesis failure was smoking. The odds of failure were significantly lower if treated by a shoulder surgeon compared to another trauma surgeon in the plate and nail group combined.ConclusionThe management of proximal humeral fracture osteosynthesis remains a controversial subject. In this retrospective analysis, a failure rate of 15.7% was calculated. Smoking is a statistically significant parameter related to osteosynthesis failure. The subspecialty of the treating trauma surgeon affected the failure rate significantly. A lower failure rate was noted after osteosynthesis by a shoulder surgeon compared to another trauma surgeon.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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