(1) Background: The treatment of proximal humeral fractures (PHFs) is debated controversially. Current clinical knowledge is mainly based on small single-center cohorts. The goal of this study was to evaluate the predictability of risk factors for complications after the treatment of a PHF in a large clinical cohort in a multicentric setting. (2) Methods: Clinical data of 4019 patients with PHFs were retrospectively collected from 9 participating hospitals. Risk factors for local complications of the affected shoulder were assessed using bi- and multivariate analyses. (3) Results: Fracture complexity with n = 3 or more fragments, cigarette smoking, age over 65 years, and female sex were identified as predictable individual risk factors for local complications after surgical therapy as well as the combination of female sex and smoking and the combination of age 65 years or older and ASA class 2 or higher. (4) Conclusion: Humeral head preserving reconstructive surgical therapy should critically be evaluated for patients with the risk factors abovementioned.

中文翻译：

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肱骨近端骨折治疗并发症风险的评估：4019 例患者的回顾性分析。

(1) 背景：肱骨近端骨折 (PHFs) 的治疗存在争议。目前的临床知识主要基于小型单中心队列。本研究的目的是在多中心环境下的大型临床队列中评估 PHF 治疗后并发症危险因素的可预测性。(2)方法：回顾性收集9家参与医院4019例PHF患者的临床资料。使用双变量和多变量分析评估受影响肩部局部并发症的危险因素。(3) 结果：骨折复杂，n = 3 个或更多碎片，吸烟，年龄超过 65 岁，和女性被确定为手术治疗后局部并发症的可预测个体危险因素，以及女性和吸烟的组合以及 65 岁或以上和 ASA 2 级或更高年龄的组合。(4)结论：对于存在上述危险因素的患者，应慎重评价保留肱骨头的重建手术治疗。