Efficacy analysis of locking compression plate combined with fibula allograft in the treatment of senile proximal humeral fractures of Neer part-III and IV

doi:10.3877/cma.j.issn.2095-5790.2021.02.010

Abstract

Abstract:

Background

Proximal humeral fractures account for 4%-5% of total fractures, in which elderly patients account for 70%, and the incidence is still increasing year by year. Locking compression plate is a common method for treatment of proximal humeral fractures, and the clinical effect is definite. However, the postoperative complication rate is very high, among which the incidence of varus deformity is as high as 71%. In recent years, fibula allograft combined with locking plate has gradually become popular in the treatment of proximal humeral fractures.

Objective

To investigate the clinical efficacy of locking compression plate combined with fibula allograft in the treatment of senile proximal humeral fractures of Neer part-III and IV.

Methods

From January 2014 to October 2019, the data of 56 patients with Neer part-III and IV proximal humeral fractures in our hospital were retrospectively analyzed. Among them, 31 cases treated with locking compression plate were divided into group A, and 25 cases treated with locking compression plate and fibula allograft were divided into group B. The Constant-Murley and ROM scores of shoulder joint function were used to evaluate the patient's limb function, the treatment effect and the occurrence of complications.

Results

There was no statistically significant difference between the two groups of basic data (P>0.05) . The postoperative Constant-Murley scores were (62.89±8.25) points in group A and (75.42±4.77) points in group B, and the difference was statistically significant (P<0.05) . The postoperative ROM scores were (18.34±4.43) points in group A and (25.77±3.84) points in group B, and the difference was statistically significant (P<0.05) . In group A, there were 1 case of humeral head varus deformity, 2 cases of screw excision and 1 case of humeral head necrosis, and the complication rate was 12.9%. In group B, there were 1 case of wound infection and 1 case of humeral head necrosis, and the complication rate was 8.0%, which was lower than that of group A with statistical difference (P<0.05) .

Conclusion

Locking compression plate combined with fibula allograft in the treatment of elderly proximal humeral fracture of Neer type-III and IV is better than those with simple locking compression plate. It can provide sufficient support and stability to the humeral head, so that patients can carry out early functional exercise smoothly after surgery, and improve the quality of life of patients after surgery.

Key words: Proximal humerus fracture, Locking compression plate, Allogeneic fibula

Yanrui Zhao, Yang Liu, Lei Shan, Junlin Zhou. Efficacy analysis of locking compression plate combined with fibula allograft in the treatment of senile proximal humeral fractures of Neer part-III and IV[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2021, 09(02): 159-163.

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References 19

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组别	例数	年龄（岁，±s）	性别（男/女）	分型（III/IV）	愈合时间（月，±s）
A组	31	74.32±6.31	10/21	20/11	4.24± 0.64
B组	25	75.15±5.82	8/13	12/9	4.81± 0.89
检验值		t=0.635	x²=0.193	x²=0.494	t=0.387
P值		0.553	0.901	0.733	0.543

组别	例数	年龄（岁，±s）	性别（男/女）	分型（III/IV）	愈合时间（月，±s）
A组	31	74.32±6.31	10/21	20/11	4.24± 0.64
B组	25	75.15±5.82	8/13	12/9	4.81± 0.89
检验值		t=0.635	x²=0.193	x²=0.494	t=0.387
P值		0.553	0.901	0.733	0.543

组别	例数	并发症[例（%）]	Constant-Mueley评分（分，±s）	ROM（分，±s）
A组	31	4（12.9）	62.89±8.25	18.34±4.43
B组	25	2（8.0）	75.42±4.77	25.77±3.84
检验值		x²=2.457	t=8.373	t=7.937
P值		<0.05	<0.05	<0.05

组别	例数	并发症[例（%）]	Constant-Mueley评分（分，±s）	ROM（分，±s）
A组	31	4（12.9）	62.89±8.25	18.34±4.43
B组	25	2（8.0）	75.42±4.77	25.77±3.84
检验值		x²=2.457	t=8.373	t=7.937
P值		<0.05	<0.05	<0.05

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