Efficacy of treatment of senile proximal humeral fracture by locking plate internal fixation
ZHAO Junjian1, CHENG Xiaobin1, ZHAI Xiaogang1, SUN Lina1, GUAN Pengfei2, ZHENG Qiang1, and BAI Jie1
1. Tangshan Branch of Hebei Provincial Corps Hospital, Chinese People’s Armed Police Forces, Tangshan 063000, China; 2. Injured Department of Tangshan Second Hospital, Tangshan 063000, China
Abstract：Objective To study the clinical effects of locking plate internal fixation for treating the senile proximal humeral fracture. Methods The clinical data of 55 patients with senile proximal humeral fracture in this hospital from August 2007 to December 2012 were analyzed retrospectively. According to Neer classification system, there were 11 cases of two-part fractures, 25 cases of three-part fractures and 19 cases of four-part fractures. We used limited open reduction with locking plate internal fixation for treatment. Self iliac bone graft was used for the 19 cases of four-part fractures. We paid attention to early postoperative functional exercise and analyzed its advantages compared with traditional methods. Results All patients were followed up for 6-18 months (average 9 months), the healing time was 11 to 15 weeks (average 13 weeks), 17 cases were evaluated as excellent, 31 cases as good and 7 cases as fair according to score of shoulder joint. The excellent and good rate was 87.3%. Two cases had incision fat necrosis with slight infection, 1 case screw penetrating joint surface, 1 case humeral head mild valgus, and 2 cases humeral head osteonecrosis. Conclusions Locking plate internal fixation for treating senile proximal humeral fracture has many advantages compared with traditional methods. This method has smaller damage, reliable fixation, allows to make early functional exercises and improves functional recovery. It is especially suitable for the senile patients complicated by osteoporosis.
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[8]
Fankhauser F, Boldin C, Schippinger G, et al. A new locking plate for unstable fractures the proximal humerus [J].Clin Orthop Relat Res, 2005,430:176-181.
Friess D M, Attia A. Locking plate fixation for proximal humerus fractures: a comparison with other fixation techniques[J].Orthopedics,2008,31(12):1234-1238.
[10]
Boileau P, Krishnan S G, Tinsi L, et al. Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus [J]. J Shoulder Elbow Surg,2002,11(5): 401-412.
Jeschid J, Zdero R, Shah S, et al. The biomechanics of locked plating for repairing proximal humerus fractures with or without medial cortical support [J].J Trauma,2010,69(5):1235-1242.
2014, Vol. 25 
