Comparative Study Of Reconstructing The Medial Column Support In Locked Plating And Half Shoulder Arthroplasty In Treatment Of Proximal Humerus Comminuted Fracture

Objective:Comparative study of reconstructing the medial column support in locked plating and Half shoulder arthroplasty in handling of proximal humerus comminuted fracture,and appraisal their curative effect,to pursue the perfect plan of of elderly patients with proximal humeral comminuted fractures.Methods:Retrospective investigation and analysis were carried out in 97 elderly patients with proximal humeral comminuted fractures who was given medical treatment in the Second Affiliated Hospital of Zhejiang University,during January 2013 and December 2015.Comparative analysis waiting time before operation,in the period of operation,the loss bleeding between intraoperation and Postoperation.Visual analogue scale were evaluated on their pain degree within 72 hours after surgery,Shoulder joint function recovery and complications were compared between the two groups by Neer shoulder function score.All data were processed by SPSS 19.0.Results:Two groups of patients with sample size,generally comparable data no significant differences.the preoperative waiting time is longer for half shoulder joint replacement group than for locking compression plate fixation group,but the operation time is shorter than locking compression plate fixation group;and the intraoperatie blood loss less than locking compression plate fixation group,postoperative bleeding loss was no significant difference between the two groups.The VAS score and Neer shoulder function score were no significant difference between the two groups.The excellence rate in half shoulder joint replacement group than is higher than that of locking compression plate fixation group.Conclusion:Half shoulder joint replacement and locking compression plate fixation with reconstructing the medial column support are availability remedies to deal with the complex proximal humerus fractures among Neer type ? and type ?.The postoperative follow-up between two groups in a short period of time obtain Satisfactory results,there was no significant difference.Half shoulder arthroplasty have a longer time before operation,but it have Short time consuming and less the loss bleeding during intraoperation,what's more,it can also have better Excellent rate on The function of the shoulder joint.Based on the foregoing advantages,Half shoulder joint replacement is a better menthod in handling of proximal humerus comminuted fracture between patients who has Advanced age or Comminuted fracture or Severe osteoporosis.Locking compression plate fixation with reconstructing the medial column support have an advantage in Protecting Soft tissue and giving stronger fixed strength.we should be fully understand of the use principle of locking compression plate fixation and biomechanics on reconstructing the medial column support.Otherwise we shoule be familier with ideal of AO internal fixation.we can have Good clinical efficacy if we have cognizance of fundamental.Department of orthopedics physicians should conside multiple factors in handling of proximal humerus comminuted fracture of Neer type III and IV,for example:age,degree of education;fuctional reqirements;physical quality,fracture complexity,therapeutic expectation.We must make a concrete analysis of each specific question...