Comparison of different internal fixation systems in geriatric humerus surgical neck fractures
Objective To compare and analyze the clinical outcomes of the ortho-bridge system(OBS)and the proximal humeral internal locking system(PHILOS)for the treatment of humeral surgical neck fractures(HSNF)in the elderly.Methods A retrospective analysis was conducted on the clinical data of 80 elderly patients with HSNF admitted to our hospital.Patients were divided into the two groups based on different surgical methods,among which 30 patients treated with OBS were included into the OBS group and 50 patients treated with PHILOS were included into the PHILOS group.The operation indicators,postoperative recovery indicators,serum bone metabolism indexes[osteocalcin(OCN),N-terminal propeptide of type Ⅰ precollagen(PINP)and alkaline phosphatase(ALP)],callus score,shoulder joint function scores[Constant-Murley scale(CMS)score and Neer score],and incidence of complications of the two groups were compared.Results The operation time in the OBS group was longer than that in the PHILOS group,and the fracture healing time was shorter than that in the PHILOS group(P<0.05).The levels of serum OCN,PINP,and ALP 1 month and 3 months after surgery in the OBS group were higher than those in the PHILOS group(P<0.05).The callus scores 1 month,2 months,and 3 months after surgery in the OBS group were higher than those in the PHILOS group(P<0.05).The CMS and Neer scores 1 month and 3 months after surgery in the OBS group were higher than those in the PHILOS group(P<0.05).The incisions of patients in the two groups recovered well after surgery,achieving gradeⅠ healing without complications such as wound infection or nonunion.Conclusion Compared with PHILOS,the application of OBS in the treatment of elderly patients with HSNF has a better short-term clinical outcome,and can promote fracture healing.