BACKGROUND: Open reduction and internal fixation is one established method for treatment of displaced @entity174 of the proximal humerus. However, the timing of surgery and its effect on complications have not yet been investigated in the literature. Hence, aim of this study was to analyze the occurrence of complication following locked plating of @entity6342 when surgery was delayed in comparison to early intervention. METHODS: Between February 2002 and November 2010, 497 @entity1 with displaced @entity6342 were treated by open reduction and locked plating. 329 @entity1 were available for follow-up with a minimum of 12 months after surgery. Outcome analysis included radiographic evidence of loss of fixation (>10   of secondary displacement), screw-cutout and avascular head @entity39 . Outcomes were analyzed with regards to age, gender and @entity174 pattern and were compared between time intervals in which the primary surgery had been conducted; early intervention (<48h), timely scheduled for surgery (3-5 days) and delayed intervention (>5 days). RESULTS: Of 329 @entity1 (68.4% @entity1 ; median age at time of surgery: 69.9 years, 95% Confidence Interval (CI) 68.2, 71.2) the median time between @entity174 incident and surgical intervention was 3.2 days (95%CI: 3.1, 3.3). Surgery was performed in a 2-part @entity174 at a median of 3.3 days (95%CI: 3.2, 3.4) after @entity130 , in a 3-part @entity174 after 3.3 days (95%CI: 3.1, 3.4), in a 4-part @entity174 2.9 days (95%CI: 2.8, 3.0), in head split type @entity174 2.2 days (95%CI: 2.0, 2.4) and in dislocation type @entity174 0.8 days after @entity130 (95%CI: 0.7, 0.9, p = 0.40). @entity819 was observed in 12.8% (n = 42 @entity1 ), of which in 4.9% (n = 16) screw cutout was evident and in 6.8% of cases (n = 20) avascular head @entity39 was diagnosed. @entity1 in which complication was observed were treated at median 2.5 days after @entity130 (95% CI, 1.8, 3.2), in comparison, @entity1 without evidence of complications were treated at a median of 3.2 days (95% CI, 2.8-3.8, p = 0.35). The odds ratio regarding occurrence of complications for @entity1 treated <48 hours was 0,924, for @entity1 in which surgery was performed 3-5 days after the incident the odds ratio was 0,836 and in @entity1 treated > 5 days the odds ratio was 1,637. CONCLUSIONS: @entity819 following open @entity6342 was not more frequently observed when surgery was performed 3-5 days after the incident in comparison to early intervention (<48h). However, a delay of intervention > 5 days is related to significant @entity455 . Thus, if open reduction and internal fixation is indicated, reconstruction of the proximal humerus should be performed within 5 days of the @entity174 event. In head split and dislocated @entity174 types anatomic reconstruction completed within 48h from the incident may be beneficial with regards to risk of @entity2530 .

Timing of surgery for open reduction and internal fixation of displaced XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients'] @entity455 :: ('MESH:D014652', 'Disease') :: ['increase of complications'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity819 :: ('MESH:C536424', 'Disease') :: ['Loss of fixation'] @entity6342 :: ('MESH:D012784', 'Disease') :: ['reduction and internal fixation of proximal humeral fractures', 'proximal humeral fractures'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma'] @entity2530 :: ('MESH:D010020', 'Disease') :: ['avascular necrosis']
@entity6342 :: (MESH:D012784,Disease) :: ['proximal humeral fractures']
