Comparative Study Of Multiloc Nailing And Philos Plate In The Treatment Of Proximal Humeral Fractures

Objective:To compare the clinical efficacy of Multiloc intramedullary nail and Philos plate in the treatment of proximal humeral fractures.Methods:From September 2014 to June 2018,65 cases of proximal humeral fractures were treated with Philosplate and Multiloc intramedullary nail,and were followed up completely.There were 21 patients in Philos plate group,aged 57.10 ± 6.449 years,including 6 males and 15 females,10 Neer type II patients and 11 Neer type III patients;44Multiloc intramedullary nails group,aged 57.25 ±8.184 years,including 13 males and 31 females,20 Neer type II patients and 24 Neer type III patients.The operation time,intraoperative bleeding volume,fracture healing time,visual analogue score(VAS),American shoulder and elbow surgeon(ASES),Constant-Murley score and shoulder range of motion were compared between the two groups.Results:All patients were followed up.Overall analysis: There was no significant difference in gender,age,fracture healing time,VAS score,neck-trunk angle and shoulder joint flexion between the two groups(p > 0.05);the operation time of Multiloc intramedullary nail group was significantly more than that of Philos plate group(83.48 ±10.775 VS 99.14 ± 10.013,p < 0.05);but the intraoperative bleeding volume of Multiloc intramedullary nail group was higher than that of Philos plate group(p < 0.05).The ASES score of Multiloc intramedullary nail group was higher than that of Philos plate group(196.50 ± 16.744 VS 240.19 ± 24.857,p < 0.05).The Constant-Murley score of Multiloc intramedullary nail group was higher than that of Philos plate group(89.07 ± 2.482 VS87.05 ± 2.418,p < 0.05).Multiloc intramedullary nail group had better shoulder rotation than Philos plate group(30.02 ± 1.959° VS 28.76 ± 1.136,p < 0.05).There was no significant difference in the curative effect of Neer type III shoulder joint between the two groups(p > 0.05).For Neer II patients,the ASES score of Multiloc intramedullary nail group was higher than that of Philos plate group 89.65 ± 2.323 VS 86.00 ± 2.404,p <0.05);the Constant-Murley score of Multiloc intramedullary nail group was higher than that of Philos plate group(86.00 ± 3.061 VS 82.10 ± 2.132,p < 0.05);the shoulder joint abduction of Multiloc intramedullary nail group was higher than that of Philos plate group(120.65° ± 11.913° VS 112.20° ± 5.922°,p < 0.05);the shoulder rotation in the Multiloc intramedullary nail group was better than that in the Philos plate group(120.65° ± 11.913°VS 112.20° ± 5.922°,p < 0.05),and the difference was statistically significant(30.60°±1.759° VS 28.90° ± 1.197°,p < 0.05).Conclusion:In the treatment of proximal humeral fractures,Multiloc intramedullary nail has more advantages than Philoss plate,with shorter operation time,less bleeding and better recovery of shoulder function.