Efficacy Research Of The Two Methods Of Treating In The Elderly Neer Three-part Fractures Of Proximal Humerus

ObjectiveTo investigate the different of clinical efficacy of conservative method and surgical method in the treatment of elderly Neer three-part fractures of proximal humerus. Analysied the two methods in Neer shoulder function score, fracture healing time, incidence of complications, quality of life and searching whether their differences make were statistical. For the clinical treatment of proximal humerus in elderly patients to provide reference and basis for Neer three-part fractures.MethodsThis study analyzed the clinical data of60patients whom met the inclusion criteria obtained all from Guangzhou University of Traditional Chinese Medicine affiliated Orthopedic Hospital during December2012to September2013period. The patients randomized by a simple principle assigned to the conservative group and surgical group,30people from conservative group accepted manipulative reduction splints, while others accept open reduction fixation. All patients during treatment accept oral medicine in the three period of fracture according dialectical theory of governance priniples. This recipes are provided by our hospital which are early prescription after injury, mid and late prescription after injury. It is regularly for us to follow up the patient, and recording relevant data in the first1month,8weeks,12weeks,24weeks. The observed indicators are shoulder function score, the degree of fracture healing, and the quantity of frozen shoulder, joint stiffness, malunion, impingement, etc. The above examination results recorded by the investigator himself under the guidance of experienced radiologists. Upon completion of data collection to establish patient information database and analyzed using statistical software. Count data using t test, measurement data with the chi-square test, comparison among groups will be measured of independent sample t test if the data is normal and homogeneous. Test level a=0.05, with P<0.05was considered statistically significant. Finally, according to statistics, clinical analysis, then derive out the corresponding conclusions.Results1. In Neer score, at the third and the forth week, the conservative group and surgery group were significantly different (P<0.01). At the eigth and the twelfth week, there shows the same difference(P<0.05) while no significant ones were found(P>0.05) after24weeks; There efficiency, at the forth week and twelfth week, compared with the surgery group had statistically significant (P<0.05) and in the24weeks, there was no difference.2. In terms of healing time between the two groups on fracture healing, no significant statistical difference was measured between the period (P>0.05).3. In terms of complications about the incidence of frozen shoulder, after4weeks, compared with operation group, the conservative group were higher and with statistically significant (P<0.05); After12weeks, the prevalence rate of frozen decreased to no statistical significant one compared with each other (P>0.05). During the ninth to twelfth weeks, the incidence of malunion, the conservative group was statistically significant compared to the surgery group(P<0.05);And in the24weeks, there shows statistical rate of impingement comes the surgery group(P<0.05);4. In terms of quality of life, both in the4th week and8th week, compared with operation group, the score of conservative group were higher and statistical (P<0.01). While at the twelfth week, the score of the two rise, and there shows the same statistical data(P<0.05). At the24th week, both group obtain the high score, and there were no statistically significant compared with each other(P>0.05).ConclusionIn the early period of elderly Neer three-part proximal humerus fractures, compared with surgery, the conservative method is more relatively of function recoverying, higher efficacy of life. But there are more adventages of Surgery from complications and function which can improve the quality and standard of living. But in the latter part of the fracture, the efficacy of the two treatment methods is quite. In therapy, from a long-term point of view, for elderly patients only meet basic living requirements or systemic conditions in general terms, conservative therapy is an effective treatment program.