Significance And Clinical Effect of Anteromedial Support Plate Assisted Reduction and Fixation in The Treatment of Complex Proximal Humeral Fractures

Abstract

XiaoTian Ma, WeiYa Zhang, Zheng Xu and Wei Sun

Background: There are more and more complex consolidated proximal fractures, and the postoperative effect is not very satisfactory. Therefore, we propose a surgical method and evaluate its effect.

Methods: A total of 77 patients with complicated proximal humeral fractures who underwent surgical treatment in the Affiliated Hospital of Nantong University from June 2015 to January 2019 were collected. Among them, the internodal groove medial support plate assisted reduction and fixation technique and the lateral locking plate were used. A total of 15 cases of complicated proximal humeral fractures were used as the study group, and 62 patients with the same type of proximal humeral fractures treated with traditional reduction methods and internal fixation with lateral locking plates during the same period were used as the control group. The operation time of the two groups; intraoperative blood loss; number of effective intraoperative fluoroscopy; postoperative humeral neck shaft angle loss after reduction; postoperative shoulder joint Constant-Murley score; upper limb function DASH score and postoperative complications were retrospectively reviewed comparative analysis.

Results: The number of effective intraoperative fluoroscopy was (6.18±1.869) times in the control group, more than (3.93±1.387) times in the study group, and the difference between the two was statistically significant (P<0.05);The operation time of the study group was longer than that of the control group, and the intraoperative blood loss of the study group was more than that of the control group, but the difference between the two was not statistically significant (P>0.05).In the first 1, 3, 6, and 12 months after surgery, in terms of imaging measurement, the loss angle after reduction of the humeral neck shaft angle in the control group and the study group increased with the increase in postoperative time. There was no significant difference in the lost angle after reduction of the humeral neck shaft angle between the two groups at month and 3 months (P>0.05).At the 6th and 12th months after surgery, the lost angle after reduction of the humeral neck shaft angle in the study group was smaller than that in the control group, and the difference between the two groups was statistically significant (P<0.05).For the recovery of shoulder joint function after surgery, the Constant-Murley score of the shoulder joint and the DASH score of upper limb function of the control group and the study group increased with the increase of postoperative time, while the Constant score and DASH score of the two groups were 1 after surgery. There was no significant difference at months, 3 months, 6 months and 12 months (P>0.05).

Conclusions: The anteromedial support plate assisted reduction of the internodal groove can be used as a single locking plate for the treatment of complex proximal humeral fractures with medial column instability. It is an option when reduction is difficult or it is difficult to maintain stable reduction, which improves the quality of reduction and reduces surgery. Loss of posterior fracture reduction.

PDF