Correlation Between Medial Column Support Of Proximal Humeral Fractures During Operation With Postoperative Radiographic Parameters And Shoulder Function

Objective:The purpose of this study was to observe the correlation between whether medial column support of proximal humeral fractures treated with anatomical locking plate fixation during operation with postoperative radiograpic parameters and shoulder function.Methods:A retrospective analysis was conducted of the eligible 59 patients with proximal humeral fractures in our institution between January 2012 and December 2014. Proximal humeral anatomical locking plate was used in all patients.According to whether medial column support of proximal humeral to divide the patients into a group of adequate medial column support(31 cases) and a group of inadequate medial column support(28 cases).Postoperative humeral head height loss, humeral head inversion angle and Constant scores of the shoulder function were observed.Results:All the patients obtained a mean follow-up of 12.5 months(range from 6 to 24 months). At the last follow-up, humeral head height loss was 0.149~4.761(1.527±1.042)mm, humeral head inversion angle was 0.046°~6.772°(2.150±1.802)° and Constant scores of the shoulder function was(78.129±7.527)in the group of adequate medial column support. However,in the inadequate medial column support group, humeral head height loss was 0.343~5.317(2.501±1.290)mm, humeral head inversion angle was 1.429°~22.978°(10.870±4.217)°and Constant scores of the shoulder function was(65.250±7.801). The group of inadequate medial column support had significantly higher humeral head height loss(t=3.206,P=0.002) and humeral head inversion angle(t=9.962,P<0.001), but Constant scores of the shoulder function(t=6.451,P<0.001)significantly lower than the adequate medial column support group.Conclusion:To maintain the postoperative humeral head height and head-shaft angle, improve the shoulder function, medial column support of proximal humeral fractures treated with anatomical locking plate fixation during operation is crucial.