Proximal humerus internal locking system combined with allogeneic femoral head bone graft for osteoporotic proximal humeral fractures in the elderly / 中华创伤骨科杂志

ABSTRACT

Objective To evaluate the efficacy of proximal humerus internal locking system (PHILOS) combined with allogeneic femoral head bone graft for the treatment of osteoporotic proximal humerus fractures in the elderly patients.Methods A total of 36 osteoporotic proximal humerus fractures were analyzed retrospectively which had been treated at Department of Orthopaedics,Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from April 2015 to April 2017.They involved 14 men and 22 women,aged from 60 to 78 years(average,67 years).By the Neer classification,20 cases were two-part fractures,11 three-part fractures and 5 four-part fractures.They were all treated by PHILOS plating combined with allogeneic femoral head bone grafting.The outcomes were assessed using Neer evaluation system for shoulder function.Results All the 36 cases were followed up for 3 to 18 months (average,12 months).All the incisions healed postoperatively by the first intention,with no postoperative infection,nonunion,humeral head varus,screw cut-out,humeral head necrosis,or loosening of implants.Clinical healing of the fractures was achieved after 8 to 24 weeks (average,12 weeks).According to the Neer evaluation,shoulder function was excellent in 18,good in 15 and poor in 3 cases.Conclusion In the treatment of osteoporotic proximal humerus fractures in the elderly,combination of PHILOS plating and allogeneic femoral head bone grafting can effectively prevent such postoperative complications as humeral head varus,screw cut-out and loosening of implants.