No additional benefit of fibular allograft augmentation in treating proximal humeral fractures

Key findings of the study:

• 80 patients were randomized in the study period.

• There were 52 women (65%), and the mean patient age (and standard deviation) was 65 ± 14 years.

• Of the 80 patients, 39 were allocated to the FA group and 41 were allocated to the LP group.

• At the primary time point (12 months), the unadjusted mean between-group difference in DASH score was 21.2 (95% confidence interval [CI], 27.3 to 5.0; p = 0.71) favoring the FA group, and, with adjustment for smoking, alcohol drinking, and diabetes, the between-group difference was 21.4 (95% CI, 27.7 to 5.0; p = 0.67) favoring FA.

• No significant differences between the 2 groups were found among the secondary outcomes.

The authors commented – “In conclusion, among adults with medial column comminuted proximal humeral fractures, FA augmentation provided no additional benefit, in either clinical or radiographic outcomes, compared with using an LP alone, within 1 year after ORIF. Similar results were found at 24 months, but were limited by the considerable loss to follow-up.”

Level of Evidence: Therapeutic Level II.

Further reading:

Effect of Fibular Allograft Augmentation in Medial Column Comminuted Proximal Humeral Fractures A Randomized Controlled Trial

Qiuke Wang, Ning Sheng et al

THE JOURNAL OF BONE AND JOINT SURGERY 2023;105:302-11

http://dx.doi.org/10.2106/JBJS.22.00746