Humeral Fractures In Elderly Research Articles

Effect of locking plate fixation for proximal humeral fractures in elderly patients

Objective To investigate the clinical effect of locking plate fixation in treatment of proximal humeral fractures in the elderly. Methods This retrospective case control study enrolled 96 patients with closed proximal humeral fractures admitted from October 2013 and October 2015. There were 52 males and 44 females, with age of (68.2±1.4)years (range, 62-74 years). According to the Neer classification of proximal humeral fractures, two-part fractures were noted in 27 patients, three-part fractures in 57, and four-part fractures in 12. According to the surgical methods, the patients were assigned to locking plate fixation (observation group) and anatomic plate fixation (control group), with 48 cases each. Operation time, intraoperative blood loss, hospitalization time, fracture healing time, varus angle of the humeral head, visual analogue score (VAS), Neer shoulder score for shoulder function and related complications were observed. Results All patients were followed up for 13-24 months (mean, 18.5 months). Better results were observed in observation group than control group in aspects of operation time [(51.2±14.8)minutes vs. (73.2±27.3)minutes], intraoperative bleeding[(158.3±32.9)ml vs. (270.9±34.8)ml], hospitalization time [(8.2±2.9)days vs. (13.1±2.2)days], fracture healing time [( 93.7±18.4)days vs. (122.9±18.9)days], varus angle of the humeral head [(2.2±1.8)° vs. (4.2±1.3)°], VAS[(2.0±0.7)points vs. (5.1±1.2)points], excellence rate of Neer score (98% vs. 90%) and postoperative complication incidence (10% vs. 21%) (P<0.05). Conclusion Compared with the anatomical plate, locking plate fixation has advantages of shorter operation time, less intraoperative bleeding, earlier bone healing, better shoulder movement and less postoperative complications in treatment of proximal humeral fractures. Key words: Humeral fractures; Aged; Fracture fixation, internal; Locking plate

Clinical outcome of proximal humeral internal locking system in treatment of three- and four-part proximal humeral fractures in elderly patients

Objective To analyze the clinical efficacy of open reduction and internal locking system (PHILOS) in management of three- and four-part proximal humeral fractures in the elderly patients.Methods A retrospective study was performed on 18 elderly patients (age≥80 years) with proximal humeral fractures who were treated surgically from June 2008 to June 2010 and received complete follow-up.The fractures were Neer three- and four-part fractures and managed with PHILOS.Rehabilitation exercise was performed postoperatively and followed up regularly. Results The patients were followed up for average 15.3 months,which showed sound healing of all fractures.Shoulder joint function was assessed by Constant-Murley score that was 55 to 83 points (mean 72.5 points) at 12 months,with an overall excellence rate of 67％. Conclusion Open reduction and fixation with PHILOS can attain satisfactory clinical outcome for the elderly patients with three- and four-part proximal humeral fractures. Key words: Shoulder fractures; Fracture fixation,internal; Aged,80 and over; Locking plate

LPHP combined with MIPO techniques for treatment of proximal humeral fractures in elderly osteoporotic patients.

Objective A prospective study was conducted to evaluate the efficacy of LPHP combined with MIPO techniques for treatment of proximal humeral fractures in elderly osteoporotic pailents.Melhods Thirty-eight elderly patients aged from 63 to 86 years with part-three and part-four fractures of the proximal humerus Were managed with the above-mentioned method between June 2003 to June 2006.Postoperative shoulder function and complications were evaluated and analyzed.Results The follow up period of the 38 cases ranged from 15 to 50 months(average 32.1 months).There was no infection,no avasculax necrosis of the humeral head,and no incidence of implant failure.Bone union was achieved in all the cases,with the mean healing period of 38 cases ranged from 14 to 27 weeks(average 18.3 weeks).According to Neer scoring,excellent in 26 cases,good in 8 cases,and fair in 4 cases.The excellent and good result rate was 89.5%. Conclusion LPHP combined with MIPO techniques is a satisfactory and effective method for treatment of proximal humeral osteoporotic fractures. Key words: Aged; Humeral fractures; Osteoporosis; MIPO