Abstract
Introduction Bilateral acute proximal humerus fractures are rare. There are no data available
about these bilateral injuries. The aim of the study was to analyse bilateral proximal
humerus fractures retrospectively in terms of incidence, complications and revisions.
Methods All bilateral proximal humerus fractures were evaluated retrospectively using the
institutionʼs database, with the focus on cause of the injury, fracture severity and
the clinical course compared to published information on monolateral proximal humerus
fractures. Bilateral posterior dislocation fractures were excluded, because these
fractures are a separate entity.
Results Between 2005 and 2016, n = 17 patients were primarily treated within our hospital
for an acute proximal humerus fracture on both sides (n = 12 female, n = 5 male, average
age: 68 years; overall 34 proximal humerus fractures). The general trauma mechanism
was a fall on both arms (82% [18% polytrauma]). There were 65% displaced 3-/4-part
proximal humerus fractures. Angle-stable plate osteosynthesis was performed predominantly
(64%), followed by fracture prosthesis (18%; tension wiring: 3%; non-operatively:
15%). Overall, n = 10 patients (59%) or n = 18 (53%) proximal humerus fractures developed
a complication, primarily with loss of reduction or implant loosening (44%). In n = 14
(78%) of the complications further operations were necessary. Alcohol abuse was increasingly
found in 29% of the cases within the bilateral patient cohort compared to patients
with monolateral fractures.
Conclusion Bilateral proximal humerus fractures are mainly associated with comminuted displaced
fractures and a higher complication rate in comparison to monolateral fractures after
surgical treatment.
Key words
proximal humerus fracture - bilateral proximal humerus fracture - both sides - humeral
head - loss of reduction
