Three Different Surgical Methods On The Clinical Treatment Of The Greater Tuberosity Fracture Analysis

Objective Assess tension band, hollow nails and wire anchors for the clinical efficacyof three internal fixation of humeral greater tuberosity fractures, and summarizes theadvantages and disadvantages of three internal fixation methods for treating humeralgreater tuberosity fracture.Methods From January2009to December2013, A retrospective survey analysis on theSecond Hospital of Tangshan, which is in Hebei Province, has gone for three fixation ofhumeral greater tuberosity fracture surgery and received follow-up of54patients,including29males and25females, aged22to71years, mean age (48.59±12.15) yearsold, and designed questionnaires and in accordance with different internal fixation group.Where tension band group (group A) has12cases, including7males and5females,mean age (49.34±10.23) years old; hollow nail group (group B) has26cases, including12males and14females, mean age (46.20±14.31) years old; anchors group (group C)has16cases, including10males and6females, mean age (44.03±15.37) years old. Byreferring to previous medical records and follow-up, Survey length of stay, the averageoperative time, the average blood loss, the average healing time, postoperativecomplication rate, good rate, postoperative shoulder function score for the past five yearsof the three groups of patients, to assess the clinical efficacy of the three humeral greatertuberosity fracture, and analyze the advantages and disadvantages of the three internalfixation. Using analysis of variance test, P <0.05was considered statistically significant.Result54cases were followed up for13to58months, with an average follow-up time(15.88±3.06) months. Three groups of patients had no postoperative infection,neurovascular injury, wound bad healing, recurrent shoulder dislocation, fracturenonunion, humeral head necrosis and so on.(1) The three groups was not statisticallysignificant (P>0.05) in the length of hospital stay; In the operative time, blood loss,fracture healing time group B was statistically significant (P <0.05) compared with groupA and C, group A and C were not statistically significant compared (P>0.05). Group Bhas shortest operation time, minimal bleeding, and fracture healing shortest time, group Aand C were not much difference.(2) The three groups were significant differences (P<0.05) in the incidence of complications, group A has the highest incidence ofcomplications, and group B has the lowest incidence of complications.(3) The three groups on the shoulder function score was statistically significant (P <0.05), group B hasthe highest score, and the lowest in group A; Group B has good rate maximum, and groupA has the minimum.Conclusion1. Tension band, hollow nails and wire anchors are all used in thetreatment of humeral greater tuberosity fracture, and each one has its advantages anddisadvantages. The choice of which internal fixation also need to consider thedisplacement of fracture, the crushing degree, patient age, comorbidities, whethernormal action, pre-injury functional shoulder and local bone quality.2. In this study, thehollow nails are often used to treat the chunks and bone mass better of the greatertuberosity fracture, and kirschner wire tension band and anchors are often used to treatcomminuted fracture or fragments smaller fractures. Besides, the anchors treat greatertuberosity fracture has more effective than the tension band.