Efficacy Research On Elderly Comminuted Of Proximal Humeral Fractures Treated With Conservative

Objective:By collecting clinical data and patient information collected,to get in a systematic and objective evaluation of the advantages and disadvantages, and clinical efficacy of the situation between conservative treatment and locking plate fixation technique during the treatment of proximal humerus fractures in elderly. The ultimate aim is to guide clinical practice.Methods:To collect outpatient and inpatient casesin which visit in Suzhou City Chinese Medicine Hospital Orthopedics during in March2010-November2012. The39proximal humerus cases which met the inclusion criteria comminuted fractures (Neer three, four) of elderly patients (>55years) were randomly divided into2groups. The treatment group of18cases were received manipulative reduction splint therapy, with the rejection of shoulder function exercise after reset. While the control group of21cases treated with open reduction locking plate fixation surgery and postoperative rejection of shoulder function exercise.There were not statistically different (p>0.05)between the two groups about sex ratio,age and type of fracture.After one year of follow-up, to compare the efficacy between the two groups, by comparing the pain visual analog scale (VAS), the standard of reset, the main function of the shoulder,and the Constant-Murley score.Results:Patients were followed up for a year, two groups of patients have received bone healing, no cases of humeral head necrosis. The treatment group no delayed union or nonunion cases; while the control group without postoperative infections occurred, but one case of delayed healing.After2weeks of follow-up,the treatment group was5.16(±2.67) about the pain visual analogue scale (VAS),while the control group was4.57(±1.32) points;and the reset excellent rate of treatment group was55.6%,while the control group was81%. After one year of follow-up groups Constant-Murley score for the treatment group was71.81±4.58, and the control group was72.27±3.41.The two groups in pain visual analog scale (VAS) and shoulder function was no significant difference (P>0.05), but the treatment group showed significantly superiority in the reset excellent rate and the pain scores, and the difference between the two was statistically significant (P<0.05).Conclusion:To contrast the Constant-Murley score system, the pain score of the treatment group was slightly worse than the control group. Because they can not achieve anatomic reduction, postoperative pain is still the most reason to impact on patient quality of life after conservative treatment, so patients functional activities and joint activity scores are not ideal, thereby affecting the upper limbs. Several score index of the control group were higher than the treatment group, but they didn’t show a clear advantage. Which is a further description that conservative treatment has the advantage of fixing outer effective, shoulder good functional recovery and low cost about proximal humerus fractures in elderly.This is one of the effective treatment of Neer three, four of fractures proximal humerus fractures in elderly.