ObjectiveTo analyze the incidence and risk factors of screw perforating humeru after internal fixation in patients with proximal humerus fractures.

MethodsThe clinical data of 125 patients treated with open reduction-internal fixation with locking plates were analyzed.The patients were divided into two groups according to whether screw perforation.Among 125 cases, 18 patients with screw perforation and 107 patients without screw perforation were found.The risk factors of screw perforation in patients with proximal humerus fractures after internal fixation were analyzed.

ResultsThe incidence rate of screw perforation in patients with proximal humeral fractures after internal fixation was 14.4%(18/125).The results of univariate analysis showed that the probability of screw perforation in patients with proximal humerus fractures complicated with medial column crushing, higher Neer type, medial column support, fewer screws and poor reduction after internal fixation were higher(P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that the Neer type, medial column crushing and poor reduction were the independent influencing factors of screw perforation after internal fixation in patients with proximal humeral fractures(P < 0.01).

ConclusionsThe probability of screw perforation in patients with proximal humerus fractures complicated with medial column crushing, high Neer type and poor reduction is high.Clinically, some measures should be taken to strengthen the fracture stability and increase the humeral head support, so as to reduce the risk of screw perforation and improve the treatment effect of patients.