The Comparative Study Of Short-term Effect On The Senile Complicated Proximal Humeral Fractur With Two Difference Kinds Of Operation Method

Objective：To analysis the treatment effect between the locking proximal humeral plate(LPHP) and humeral head replacement (HHR) in the senile complicated proximalhumeral fracture.Methods：A review study was conducted on29elder patients who were admitted to ourDepartment with osteopotic complicated proximal humeral fracture from June2010toMay2012,17cases were treated with LPHP,7males and10females,average76.4yearsold,and12cases with HHR,5males and7females,average78.6years old. According toNeer classification, there were17cases of type Ⅲ，12cases of type Ⅳ。All cases wereassisted by active and passive exercise after operation.Count on the length of operativeincision, operation time, amount of bleeding in operation, the duration of hospitalization,postoperative complications and curative effect.Rsults：HHR is better than LPHP in the length of operative incision, the operation timeand amount of bleeding in operation.All patients without postoperative infection andneurovascular injury. All the patients were followed up by12(ranging10～17) monthsaveragely。6cases of complications were occured in locking plate group,humeral head necrosis in1, delayed union in2, internal fixation failure in1,varus malunion in2.TheHHR group presented prosthesis loosening in1cases. The incidence of complicated was35.3%,8.3%,significant difference among two groups(P<0.05). HHR group in shoulderabduction, external rotation is superior to internal fixation group (P<0.05).Conclusion：Humeral head replacement for the treatment of senile proximal humeralIII,IV fractures with less trauma, postoperative shoulder function recovered satisfactorily,the complication rate is low. Some elder patients with humeral head necrosis orosteoporotic complicated proximal humeral fracture should be given to the use of HHRpriority.