NDLI: The VIDIA BONE score as a patient- and fracture-related risk score for the occurrence of fracture sequelae in proximal humerus fractures

Content Provider	Springer Nature : BioMed Central
Author	Kimmeyer, Michael Liebherr, Norbert Schmalzl, Jonas Rentschler, Verena Gerhardt, Christian Lehmann, Lars-Johannes
Abstract	Purpose The aim of the study was to determine preoperative patient- and fracture-related risk factors for estimating the risk of fracture sequelae after surgically treated proximal humerus fractures (PHF) using locking plate osteosynthesis. The purpose was to develop a fracture sequelae risk score as an additional tool to facilitate the treatment strategy for PHF. Methods All patients with PHF who underwent surgery with locking plate osteosynthesis were included. Inclusion criteria were complete preoperative parameters including general patient-specific information, preoperative radiographs and computed tomography (CT) scans. The patients were divided into 2 groups according to the occurrence of fracture sequelae (Group I: no fracture sequelae, Group II: fracture sequelae). Following risk factors for fracture sequelae were defined: Vascular supply interruption risk [V], Individual (female gender) [I], Diabetes [D], ISAR (Identification of Seniors at risk) [I], ASA (American Society of Anesthesiologists) score [A], Body mass index [B], Osteopenia [O], Nicotine abuse [N], Elderly > 65 [E]. The VIDIA BONE score contains 9 items. For each parameter of the VIDIA BONE score, a value between 1 and 3 was assigned based on the odds ratio (OR). Results This comparative case series study included 112 patients, with 82 (73.2%) in Group I and 30 (26.8%) in Group II. All defined preoperative risk factors were associated with an increased risk of fracture sequelae (FS), with odds ratios (OR) ranging from 1.3 to 3.9, although not all parameters reached statistical significance. The maximum score was 24 points, categorized as follows: scores of 1 to 8 indicating low risk, 9 to 16 indicating moderate risk, and 17 to 24 indicating high risk of fracture sequelae following PHF. Patients with a VIDIA BONE score of 1 to 8 points demonstrated favorable postoperative outcomes, with FS observed in only 6% of cases. In contrast, 84% of patients with a score of 17 to 24 developed a FS. Additionally, 90% of all patients who developed FS had a VIDIA BONE score more than 9 points. Conclusion The VIDIA BONE score appears to be a simple, reproducible, and valuable tool for supporting reliable treatment decisions. Locking plate osteosynthesis is an effective treatment option for patients with a low risk VIDIA BONE score. However, patients with a high risk VIDIA BONE score are more likely to experience FS and osteosynthesis failure. Level of evidence III.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-024-08156-9.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-024-08156-9
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2024-12-20
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Avascular humeral head necrosis Pseudarthrosis Reverse shoulder arthroplasty Plate osteosynthesis ASA score Metabolic syndrome
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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