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Chinese Journal of Trauma ; (12): 402-406, 2012.
Article in Chinese | WPRIM | ID: wpr-426316


ObjectiveTo analyze the clinical outcome of locking plate and hemiarthroplasty in treatment of Neer three- and four-part proximal humeral fractures.Methods A totalof 63 consecutive patients aged over 55 years with Neer three- and four-part proximal humeral fractures were treated surgically from June 2006 to June 2010.In the retrospective study,36 patients were treated by open reduction and locking plate fixation ( locking plate fixation group) and 27 patients treated by hemiarthroplasty (hemiarthroplasty group).Clinical outcomes including operation time,blood loss,visual analog scale ( VAS),Constant-Murley score and complications were evaluated.ResultsThe average 19.7 months follow-up showed complication rate of 28% in the locking plate group,including one patient with varss malunion,one with axillary nerve injury,one with humeral head necrosis,one with heterotopie calcification and four with impingement syndrome.The complication rate was 24% in the hemiarthroplasty group,including two patients with tuberosity nonunion,one with tuberosity migration,one with impingement syndrome and one with joint semiluxation.The mean Constant-Murley score of three-part fractures in the locking plate group was ( 76.5 ±5.8) points,better than (69.2 ±7.2) points in the hemiarthroplasty group (P <0.05 ).While the two groups showed no significant differences with regards to operation time,blood loss and visual analog scale (VAS).As for the four-part fractures,the mean operation time was shorter and the mean blood loss was less in the hemiarthroplasty group compared with the locking plate group (P <0.05),while there were no obvious differences in VAS score and Constant-Murley score between the two groups. Conclusions Both locking plate and hemiarthroplasty are the reliable methods for the three- and four-part proximal humeral fractures.The patients' age,bone quality,fracture type,comminution degree and evaluation of osteonecrosis possibility,are critical for surgery decision.