A Retrospective Study Of Two Methods Of Internal Fixation For The Treatment Of Humerus Greater Tuberosity Fractures

Subject: Discuss clinical effect of two kinds of internal fixation surgery for the treatment of humerus greater tuberosity fractures.Materials and methods:This study is a retrospective analysis of 48 patients with humerus greater tuberosity fractures,who were treated and well followed-up by the Second Affiliated Hospital of Dalian Medical University from January 2013 to June2015.26 patients with fractures of humerus greater tuberosity who were treated by open reduction and internal fixation with cannulated screws were as the experimental group(screw group,A group),Select other 22 cases(which were treated at the same period)with locking proximal humerus plate fixation as control(plate group,B group),respectively,Two groups of patients were using deltoid muscle surgical incision and standard surgical approach between the pectoralis major muscle deltoid muscle.Two groups of patients were treated in the same period,and the general information(include gender,age,causes,left or right side,time of injury to the operation and.etc)of them has no statistically significant differences(P>0.05).All patients were followed up,once per month in the first half year after surgery,then once every 3 months,use Constant-Murley shoulder grading system to assess functional prognosis.To evaluate the two kinds of internal fixation surgery by analysis and comparison of two groups of patients in time of surgery,intraoperative blood loss,hospital stay,time of healing,incidence of postoperative complications and good rate of clinical.Result:The surgery of the selected 48 cases of patients in this study were completed successfully,and followed-up regularly.Collected data were processed by using SPSS17.0 statistical software,the results showed that : the intraoperative blood loss of the two groups were 54.62±3.98 m L and 55.91±4.54 m L,respectively;the hospital stay were 7.08±0.94d、7.09±0.81 d,respectively;the time of healing were 13.23±0.68week、12.98±0.66 week,respectively;and the incidence of postoperative complications were7.69%、4.55%,respectively.By statistical analysis,there were no significant differences between screw group and plate group in four indicators above(P>0.05).Scores of Constant-Murley: Good rate of internal fixation with cannulated screws were 80.8%(3rd month),92.3%(6th month),locking plate fixation were 77.3%(3rd month),81.8%(6th month),there were no significant differences between two kinds of internal fixation methods in good rate of clinical(P>0.05).However,the time of surgery was statistically differences between two grous,group A(52.62±7.62min)was shorter than group B(95.50±7.68min).Conclutions:Cannulated screws and locking plate fixation are both good treatments of humerus greater tuberosity fractures,but both of them have its best clinical indications,advantages and disadvantages.Therefore,the situation of displacement,the size,the degree of comminution,the bone condition of fracture fragments and other factors of patients should be considered in clinical practice by surgeons.