Article
Comparison Of The Clinical Effect Of The Internal Fixation Combined With Bone Graft And The Replacement Of The Humeral Head With The Semi-Shoulder Arthroplasty For The Treatment Of The Proximal Humerus Fracture
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Published: | October 22, 2019 |
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Objectives: Comparative analysis of allogeneic bone grafting with locking plate fixation and semi-shoulder arthroplasty for the treatment of the proximal humerus fracture of Neer three or four fracture.
Methods: Retrospective analysis of July 2012 to July 2017, our hospital treated 49 cases of age = 60 years old proximal humerus Neer three or four fracture of patients' clinical data, of which 27 cases with allogeneic bone graft with locking plate fixed treatment (bone graft LCP group), semi-shoulder arthroplasty (SSA group) 22 cases. The patients were followed up for 8-24 months. The operation time, intraoperative blood loss, Constant score, Neer score, VAS pain score and complication were recorded and compared between the two groups.
Results: There were no complications such as infection, nerve injury, prosthesis loosening, fixation screw detachment and fracture around the joint. There was no significant difference in operation time and intraoperative blood loss between the two groups (P> 0.05). There was no significant difference (P> 0.05) between the mean total score of Neer, the average score of Neer and the SSA group in the LCP group. There were significant differences in VAS score between the two groups (P <0.05). The difference of VAS score between the two groups was statistically significant (P <0.05).
Conclusions: For the elderly three or four parts of the proximal comminuted humerus fractures, allogeneic bone transplantation to strengthen the locking plate fixation and semi-shoulder arthroplasty is an effective treatment, similar efficacy between the two groups. The final choice of treatment options should be based on the patient's physical condition, proximal humerus blood destruction, bone conditions and the experience of the surgeon comprehensive decision.