Does a Learning Curve Exist for the Surgical Treatment of Proximal Humerus Fractures?
Egol, K.A.; Shulman, B.S.; Belayneh, R.; Karia, R.J.; Zuckerman, J.D.
Bulletin of the Hospital for Joint Disease 76(4): 265-268
2018
ISSN/ISBN: 2328-5273 PMID: 31513512 Document Number: 697294
The complication rate of locked plating for proximal humerus fractures remains stubbornly high. The purpose of this study was to determine if a learning curve exists with the operative treatment of proximal humerus fractures. We prospectively followed 161 consecutive patients with proximal humerus fractures treated by a single surgeon with locked plates from 2005 to 2016. Radiographic data, functional outcomes, and complications from the surgeon's first 81 patients were compared to the subsequent 80 patients. There was no statistical difference in the rates of complications (p = 0.29) or screw penetration (p = 0.19). There were no differences in DASH scores (p = 0.64 to 0.79) or tip-apex distance (p = 0.40). Head shaft angles were slightly smaller in patients treated earlier in the surgeon's career (p = 0.02). While surgeon experience is certainly a favorable quality, there does not appear to be a significant "learning curve" in the treatment of proximal humerus fractures.