Comparison of locking plate and hemiarthroplasty for three and four-part proximal humeral fractures in the ;elderly
XIE Xiao-tao
ZHOU Jun-jie
L Shun
GAO Wen-wu
CHEN Xian-qi
LIU Cheng-yi
ZHANG Lei
Abstract：Objective To directly compare the locking compression plate and hemiarthroplasty for three and four-part proximal humeral fractures in the elderly. Methods The records of 60 consecutive patients who were 60 years of age or older and in whom a Neer three or four-part proximal humeral fracture had been treated surgically between October 2011 and October 2014;29 patients treated with a locking compression plate were compared with 31 patients who had undergone hemiarthroplasty. Outcome measurements included Constant and Neer scores, evaluation of local pain at the fracture site and complications. Results Both of the mean Constant score at the time of ifnal follow-up between locking compression plate and hemiarthroplasty were satisfactory. There was no signiifcant difference between LCP group ( 74.7 ± 14.1 ) points and HHR group ( 81.6 ± 8.67 ) points ( P>0.05 ). The LCP group had an excellent outcome rate of 62.07%. The HHR group had an excellent outcome rate of 70.97%. There was no signiifcant difference between the treatment outcomes of the mean Constant score ( P>0.05 ). The mean Neer score of LCP group ( 80.0 ± 11.8 ) points and HHR group ( 83.8 ± 9.0 ) points had no signiifcant difference ( P>0.05 ). The VAS score at the time of three weeks, three months and one year between two groups showed a better effect with hemiarthroplasty. The scores of LCP group were ( 4.30 ± 1.54 ) points, ( 4.10 ± 1.44 ) points and ( 3.92 ± 1.47 ) points. The scores of HHR group were ( 3.50 ± 1.43 ) points, ( 3.10 ± 1.29 ) points, ( 2.85 ± 1.26 ) points. Two groups of cases had no signiifcant difference in operation time, blood loss, hospitalization days and complications. Conclusions Locking compression plate and hemiarthroplasty can be considered as useful implants for three and four-part proximal humeral fractures in the elderly. The ultimate choice of treatment should be made according to the patient’s physical condition, blood supply and patients’ bone quality and surgical techniques and so on.
Keywords：Humeral fracturesFracture ifxationinternalShoulder fracturesShoulder jointHumeral headShoulder prosthesis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 647-652 )