Clinical comparative study of metaphyseal locking intramedullary nail and locking plate in the treatment of humeral surgical neck fracture / 中国医师杂志

ABSTRACT

Objective@#To investigate the difference of clinical efficacy between metaphyseal locking intramedullary nail and locking plate in the treatment of humeral surgical neck fracture.@*Methods@#64 patients with Neer II humeral surgical neck fracture who were treated in our hospital from January 2010 to December 2015 were selected. According to the operation plan, the patients were divided into epiphyseal locking intramedullary nail fixation group (observation group, n=42) and locking plate fixation group (control group, n=22). The differences of clinical data (sex, age, time from injury to operation, number of injured cases, follow-up time), clinical indicators (neck-trunk angle, last neck-trunk angle, number of complications, amount of operative bleeding, amount of operative blood transfusion, operation time, fracture healing time) Neer shoulder function score and Constant shoulder score were compared between the two groups.@*Results@#There was no significant difference in gender, age, time from injury to operation, number of cases of injury and follow-up time between the two groups, and the subjects were comparable (P>0.05). There was no significant difference in the neck-trunk angle, the last neck-trunk angle and the number of complications between the two groups (P>0.05); the observation group had longer operation time, less operation bleeding volume and blood transfusion volume, shorter fracture healing time (P<0.05). Two cases of wound infection occurred in the observation group and the control group after operation. The wound healed after anti-infection supportive treatment and dressing change. The excellent and good rate of Neer shoulder function score in the observation group was 88.10%, which was significantly higher than 63.64% in the control group (P<0.05). There was no significant difference in internal rotation between the two groups (P>0.05). The Constant score, external rotation, abduction and flexion in the observation group were significantly higher than those in the control group (P<0.05).@*Conclusions@#The use of metaphyseal locking intramedullary nail in the treatment of humeral surgical neck fracture has a definite clinical effect and a low incidence of complications, which is worthy of clinical application.