Objective To explore the clinical benefits of digital simulation surgery in the limited open reduction and intramedullary nail fixation for treatment of proximal humeral fractures.Methods A retrospective study was conducted to analyze the clinical data of 40 patients who had been treated by limited open reduction and intramedullary nail fixation at Department of Trauma and Orthopedics,The People's Hospi-tal of Weifang from June 2020 to September 2022 for 3-part proximal humeral fractures by Neer classification.The patients were assigned into 2 groups according to different preoperative strategies.In the observation group of 17 patients[4 males and 13 females with an age of(66.9±8.6)years],the angle of intramedullary nail placement into the humeral head and the sequence of reduction and fixation were simulated in the preoperative digital simulation surgery.In the control group of 23 patients[7 males and 16 females with an age of(63.0±8.6)years],routine reduction and fixation were performed based on the preoperative shoulder joint CT images and intraoperative fluoroscopy without preoperative digital simulation surgery.The 2 groups were compared in terms of operation time,intraoperative blood loss,intraoperative fluoroscopy frequency,incidence of postopera-tive complications,fracture healing time,active range of motion of the shoulder joint at the last follow-up,as well as the intramedullary nail heights,humeral neck-shaft angles,Constant shoulder function scores,and vi-sual analogue scale(VAS)pain scores at 3 days,12 weeks,and 24 weeks postoperatively.Results The 2 groups were comparable because there were no statistically significant differences in the preoperative general data between them(P＞0.05).The operation time in the observation group[(57.5±6.2)min]was signifi-cantly shorter than that in the control group[(71.3±10.2)min],and the intraoperative fluoroscopy frequency in the former[(28.5±4.4)times]significantly lower than that in the latter[(45.4±2.6)times](P＜0.05).The 2 groups were followed up for(15.0±1.6)months.For the observation and the control groups,respectively,the fracture healing time was(10.5±2.4)weeks and(10.0±2.0)weeks,showing no statisti-cally significant differences between groups(P＞0.05).There were no statistically significant differences be-tween the 2 groups in the intraoperative blood loss,or in the intramedullary nail heights,humeral neck-shaft angles,Constant shoulder function scores,or VAS pain scores at 3 days,12 weeks,or 24 weeks postoperative-ly,or in the active range of motion of the shoulder joint at the last follow-up(P＞0.05).Complications such as infection,humeral head necrosis,and screw removal occurred in none of the patients.Conclusion In the treatment of proximal humeral fractures,before the routine limited open reduction and intramedullary nail fixation,digital simulation surgery can be performed to reduce the operation time and fluoroscopy frequency without sacrifice of the therapeutic efficacy.
维普
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