Comparison of the efficacy of PHILOS plate and Multiloc intramedullary nail in the treatment of elderly proximal humerus fractures
Objective To investigate the clinical effect of PHILOS plate and Multiloc intramedullary nail in the treatment of el-derly proximal humerus fractures.Methods Forty-nine patients were divided into PHILOS plate group having 57 cases and Multiloc intramedullary nail group having 49 cases.In the plate group,there were 26 males and 31 females,aged from 59 to 87 years old with an average age of 67.12±6.66 years old.There were 23 cases belonging to Neer type Ⅱ,25 cases in Neer type Ⅲ,and 9 cases in Neer type Ⅳ.In the intramedullary nailing group,there were 21 males and 28 females,aged from 60-78 years old,with an average age of 69.49±6.10 years old.There were 21 cases in Neer type Ⅱ,20 cases in Neer type Ⅲ,and 8 cases in Neer type Ⅳ.The operation time,the number of C-arm fluoroscopy,the amount of blood loss,the time of fracture healing,the cervical trunk Angle and the JOA score of shoulder joint function were recorded one year after the operation,and the curative effect was analyzed and evaluated.Results Opera-tion time was 60-180 minutes in plate group,and average time was 112.75±4.70 minutes.In the intramedullary nailing group,the mean time was 79.79±3.10 minutes(t=6.336,P=0.001)from 50 to 130 minutes.The C-arm fluoroscopy mean times were 9.08± 2.63 times for 6-20 times in the plate group and 9.57±2.35 times for 6-12 times in the intramedullary nail group(t=-1.032,P=0.307).Blood loss was 303.06±79.98 ml in plate group and 265.31±55.16 ml in intramedullary nail group(t=2.692,P=0.010).The average follow-up was 12.08±2.91 months for the plate group and 12.37±2.36 months for the intramedullary nail group(t=-1.436,P=0.157)for 13-18 months.One year after surgery,the cervical trunk Angle was 129.47±6.40° in the plate group and 133.33±4.93° in the intramedullary nail group(t=-3.481,P=0.001).One year after surgery,JOA functional score was 78.80±4.27 in the plate group and 80.29±3.86 in the intramedullary nail group(t=-1.959,P=0.056).Failure of internal fixation occurred in 2 cases in plate group and 1 case in humeral head necrosis.Conclusion Locking plate and intramedullary nail are both effective treatments for proximal hu-merus fractures,but intramedullary nail method has advantages in terms of operation time,blood loss,and fracture reduction.
Fractures of the proximal humerusPHILOS steel plateMultiloc intramedullary nail
NETL
NSTL
万方数据
