Venous thromboembolism following surgical management of proximal humerus fractures: a systematic review

Authors

Erick M. Marigi, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
John W. Sperling, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Rodrigo De Marinis, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Puneet Gupta, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Leslie C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
Francisco Soza, Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Joaquin Sanchez-Sotelo, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.

Document Type

Journal Article

Publication Date

11-1-2023

Journal

JSES reviews, reports, and techniques

Volume

3

Issue

4

DOI

10.1016/j.xrrt.2023.06.003

Keywords

Deep vein thrombosis; Hemiarthroplasty; Open reduction internal fixation; Proximal humerus fracture; Pulmonary embolism; Reverse total shoulder arthroplasty; Venous thromboembolism

Abstract

BACKGROUND: Currently, there is limited information on the incidence of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) after surgical treatment of proximal humerus fractures (PHFs). Therefore, the purpose of this systematic review is to evaluate the incidence of VTE, DVT, and PE following surgery for PHFs. METHODS: A comprehensive search of several databases was performed from inception to May 27, 2022. Studies were screened and evaluated by 2 reviewers independently utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only original, English studies that evaluated the incidences of VTE following surgical management of PHFs were included. Surgical procedures consisted of shoulder arthroplasty (SA) including both hemiarthroplasty (Hemi) and reverse shoulder arthroplasty (RSA) in addition to open reduction and internal fixation (ORIF). A pooled incidence for postoperative DVT, PE, and overall VTE was reported. RESULTS: Twelve studies met the inclusion and exclusion criteria, encompassing a total of 18,238 patients. The overall DVT, PE, and VTE rates were 0.14%, 0.59%, and 0.7%, respectively. VTE was more frequently reported after SA than ORIF, (1.27% vs. 0.53%, respectively). Among SA patients, a higher rate of DVT was seen with RSA (1.2%) with the lowest DVT rate was observed for ORIF with 0.03%. CONCLUSIONS: Symptomatic VTEs following surgical treatment of PHFs, are rare, yet still relevant as a worrisome postoperative complication. Among the various procedures, VTE was the most frequently reported after SA when compared to ORIF, with RSA having the highest VTE rate.

APA Citation

Marigi, Erick M.; Sperling, John W.; De Marinis, Rodrigo; Gupta, Puneet; Hassett, Leslie C.; Soza, Francisco; and Sanchez-Sotelo, Joaquin, "Venous thromboembolism following surgical management of proximal humerus fractures: a systematic review" (2023). GW Authored Works. Paper 3870.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3870

Department

School of Medicine and Health Sciences Resident Works