Comparison Of Locking Proximal Humerus Plate And Normal Plate In Treatment Of Proximal Humerus Fractures In Aged Osteoporptic Population

Background:With the aging of the population, the incidence of fracture which associated with the osteoporosis showed a rising trend. The incidence of proximal humerus fractures was higher than the other parts of the body in the population of age over 60.Young patients were usually caused by high-energy trauma, but a minor trauma could cause significant damage in the elderly patients with osteoporosis. And the proximal humerus fractures occurred in the higher age, whose results would be more serious. In order to get a good healing effect of the proximal humerus fractures, and get a better shoulder function, most scholars believed that the unstable fractures need surgical treatments. However, not all of the internal fixation not only met the required stability, but also met the needs of early functional exercise. In addition, the surgical treatment for the compleaxity of displacement proximal humerus fractures should be restore the anatomical reconstruction with sufficience of the blood supply, so that fracture would get a better healing.With the development of various medical technologies, the knowledgement of proximal humerus fractures had been deeper and deeper. Many new treatments had been applied to. According to Neer proposed that the classification of proximal humerus fracture was according to the number of fractures and the shifting, most scholars bleieved that the conservative treatment which had been treated for the non-displace fracture would be able to get a desired result. But which treatment we should choose for those with displaced fractures, especially the three-part and four-part fractures, it had a variety of views, and it still was the focus of contention. Many scholars had a common view that the fracture in the elderly patients who had osteoporosis should be treated for arthroplasty in the early. But this treatment was expensive and could not be accepted by the majority of patients.With the improvement of the internal fixation materials and the medical technologies, it had been a new progress in the treatment of the proximal humerus factures in the elderly with osteoporosis.LPHP is a special plate whose design is based on local anatomical characteristics and biomechanical properties. Because of its unique angling and locking principle, that makes the screw has a better anchoring force and tensiling strength to prevent screw's loosening for the osteoporosis and the comminuted fractures. LPHP is a new type of fixation material in the treatment of proximal humerus fractures.Objective:To compare the clinical results of Locking Proximal Humerus Plate and Normal Plate in treatment of proximal humerus fractures in aged osteoporotic population.Methods:The clinical data concerning 23 patients,who were the elder with proximal humerus fractures and osteoporosis in our hospital from November 2007 to February 2010, were analyzed retrospectively. There were 11 patients who had be treated by the Locking Proximal Humerus Plate, mean age was 68 (range 60-79 years old); The others were treated by the Normal Plate, mean age was 69 (range 60-85 years old).The mean follow-up time was 15.3 months (range 12-22 months).We compared two groups in operation time, the volume of blood transfusion, bones healing after operation, function of shoulder, necrosis of humerus head, the rate of the interal fixation damagement and loosening and shoulder scores, etc.Results:Comparison showed that the results for LPHP group were statistically better than those for NP group in the shoulder scores and the rate of interal fixation damagement and loosening. The operation time and the volume of blood transfusion was significantly less in LPHP group than in NP group.Conclusion:LPHP has an obvious advantage over NP in treatment of proximal humerus fractures in aged osteoporotic patients.LPHP facilitated healing of the bone in reducing the operation time,the volume of intraoperative bleeding, the intraoperative injury and the damagement of bone blood supply.LPHP reduced the rate of the interal fixation damagement and loosening, because the screws hold well in the osteoporotic patients. That was good for the early functional exercise and recovery.LPHP was significantly better as compared with NP for provimal hulmerus frastures in aged osteoporotic population.