Clinical observation of proximal humeral locking plate combined with suture anchor in the treatment of shoulder dislocation with greater tuberosity fracture in the elderly patients

CAI Gui-quan; HE Ji-ye; WANG Hui; ZHANG Jia-hong; WANG Dong-liang

doi:10.3969/j.issn.2095-252X.2019.03.003

Abstract：Objective To explore the results of proximal humeral locking plate combined with suture anchor in the treatment of shoulder dislocation with greater tuberosity fracture in the elderly patients. Methods From January2013 to October 2017, 30 elderly patients of shoulder dislocation and greater tuberosity fracture were divided into observation group and control group according to different surgery plans. After reduction of shoulder dislocation, the greater tuberosity displaced＞ 5 mm in all patients. Proximal humeral locking plate combined with suture anchor were used intraoperatively to reduce and fix the greater tuberosity and repair the rotator cuff in observation group, while proximal humeral locking plate was used only to fix the greater tuberosity. Preoperative and postoperative shoulder function was evaluated by range of motion, VAS score and Constant-Murley score. Results All patients were followed up for 12 to 18 months. There were no significant differences in the mean healing time between the 2 groups ( P＞ 0.05). Postoperative VAS scores of the 2 groups were obviously lower than those of the corresponding groups preoperatively, the differences were statistically significant ( P = 0.000); but there were no significant differences between the 2 groups postoperatively ( P = 0.200). Postoperative Constant-Murley score of the 2 groups were obviously higher than those of the corresponding groups preoperatively, the differences were statistically significant ( P = 0.000). Constant-Murley score of the observation group was obviously higher than that of the control group, the differences were statistically significant ( P = 0.032). According to the functional rating, the excellent and good rate of the observation group was 86.67％, while that of the control group was only 66.67％. There were no obvious complications in the observation group, but 5 cases in the control group had displacement of fracture mass of humeral greater tuberosity and 2 cases had subacromial impingement syndrome. Conclusions Proximal humeral locking plate combined with suture anchor in the treatment of shoulder dislocation with greater tuberosity fracture in the elderly patients provides stable fixation with less complications.