Core set of unfavorable events of proximal humerus fracture treatment defined by an international Delphi consensus process

Table 2 Definitions and specifications of intraoperative event groups^a

Event group	Definition and specification
Device events	Events affecting any component of the implanted device or material, or the instrumentation used for their implantation.
Device events	• Instrument problem (breakage, failure) • Implant (breakage, malpositioning, separation, separation, screw/bolt joint surface perforation requiring immediate postoperative surgical revision) • Cementation problems (augmentation)
Osteochondral events	Events affecting the osteochondral tissue of the proximal humerus, clavicula and/or scapula
Osteochondral events	Articular cartilage damage • iatrogenic Fracture (including hairline fracture): humerus metaphyseal (proximal to “surgical neck”); humerus diaphyseal; scapula
Soft tissue events	Events involving only the soft tissue at the treated shoulder
Soft tissue events	• Skin, muscle, tendon, joint capsule, ligament, labrum • Blood vessels (bleeding): bleeding at the surgical site that requires additional intervention or leads to a stop of the operation • Nerves^b: recognized damage of a neurological structure

^aAdapted from Audige et al. (Audige et al. 2016, Audige et al. 2019). An intraoperative event is any event that occurs or is recognized during the time interval between skin incision and skin closure. When the fracture is reduced under anaethesia in the context of non-operative management, an equivalent “fracture reduction” period is considered as the time interval between the patient entered the operating room (OR) and the time the patient exited the OR
^bA standard list of potentially affected nerves is only presented for postoperative neurological events. Contrary to the CES in shoulder arthroplasty, damages of neurological structures were not restricted to those which needed additional surgical intervention

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