Bone/fracture | |
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(Secondary) Loss of reduction = secondary fragment displacement = redisplacement | Significant change of head position against shaft or fragment dislocation compared to the immediate postoperative position |
= secondary dislocation of greater tuberosity | Relative change of greater tuberosity compared to the immediate postoperative position |
Malunion | Fracture healed with deformity and bone unites in abnormal position and/or alignment (e.g. varus/valgus, rotational malunion) |
1. as a consequence of loss of reduction | |
2. as a consequence of inadequate/insufficient anatomical reduction as observed on postoperative X-rays. | |
Delayed healing | Insufficient signs of bridging/continuous fracture line still visible up to 6 months |
Nonunion | Indiscernible signs of bridging/continuous fracture line still visible after 6 months |
Head impaction = secondary fracture impaction | Secondary impaction/sintering of the head fragment with consecutive intraarticular screw penetration due to mechanical failure (not due to avascular collapse of the head fragment) compared to immediate postoperative position |
Head necrosis | In situ death of bone within the humeral head due to disruption of blood supply, leading to partial or complete collapse of the head |
Refracture = secondary fracture at the same site | After fracture is healed: refracture occurs at the same humeral site with a load level otherwise tolerated by normal bone after the bone has solidly bridged |
Functional deficit | As assessed with the functional scores of DASH, SPADI, ROM and Constant-Murley |
Implant/surgery | |
Primary malpositioning of plate | Failure to fix each fragment and/or failure to implant plate according to technical guide [18] (including anatomical reduction and plate positioning i.e. at least 8 mm distal to the upper end of the greater tubercle) during operation |
Primary malpositioning of screw | Screw perforation into glenohumeral joint during operation |
Secondary screw loosening: back-out | Relative change outwards of screw position in relation to postoperative position |
Secondary screw loosening: perforation | Perforation of one screw through the cortex of the head (no initial perforation) |
Implant loosening = Proximal screw and plate pull out = Distal screw and plate pull out | Multiple proximal or distal screw loosening leading to firstly, relative movement between one main fragment and the plate and secondly, pull-out of the implant |
Implant failure/breakage | Plate/screw breakage |