Comparison Of The Effect Of Philos Locking Plate Internal Fixation And Humeral Head Replacement In The Treatment Of Complex Proximal Humeral Fractures In The Elderly

Objective:In recent years,the incidence of proximal humerus fracture is on the rise,and the choice of related treatment options has become a hot topic.At present,the common surgical techniques for the treatment of such fractures are Philos locking plate internal fixation and artificial shoulder arthroplasty.Based on retrospective analysis,this paper compares the clinical efficacy of Philos locking plate and artificial shoulder replacement in the treatment of complex proximal humerus fracture,and provides reference for future clinical work.Methods:We selected 35 patients with Neer Ⅲ-Ⅳ partial fracture classification of proximal humerus in trauma orthopedics in China-Japan union hospital of jilin university from January 2016 to December 2018,including 18 cases in internal fixation group and Philos locking plate internal fixation,including 12 cases of three-part fracture and 6 cases of four-part fracture.In addition,there were 17 cases of Humeral head replacement group,including 11 cases of three-part fracture and 6 cases of four-part fracture.By comparing the operative time,the blood loss,hospitalization time,fracture healing time and Constant-murley shoulder function scores of the two groups,the curative effect of the two surgical methods was compared Results:The operative time,blood loss and fracture healing time of Humeral head replacement group were less than those of Philos locking plate group(p<0.05),The hospitalization time of Philos locking plate group was less than that of Humeral head replacement group(p>0.05).By comparing Constant-murley functional score of shoulder,Philos locking plate group was lower than that of Humeral head replacement group at one and three months after operation(p<0.05).There was no significant difference between the two scores at six months after operation(p>0.05).And the grade of Philos locking plate group was higher than that of Humeral head replacement group at 12 months after operation(p <0.01).Conclusion:Philos locking plate internal fixation and Humeral head replacement can achieve good results in the treatment of complex proximal humerus fractures in the elderly,but from the long-term effect of shoulder function recovery,Philos locking plate is better than Humeral head replacement in the treatment of complex proximal humerus fractures in the elderly.