| Objectives Compare the curative effect of two different internal fixation methods using cannulated screw and anatomical plate in treating the fracture of the greater tuberosity of humerus, to provide reference for clinical choice.Methods Collect the clinical case data of fracture of the greater tuberosity of humerus admitted by Department of orthopedics Affiliated Hospital of North China University of science and Technology(The second hospital of Tangshan) from January 2008 to December 2014, and choose 85 cases which treating the fracture of the greater tuberosity of humerus by using cannulated screw or anatomical plate to proceed the open reduction and internal fixation through strict inclusion and exclusion criteria. Collection and record the related cases, imaging data, operation data and follow-up records, and carry on a retrospective statistical analysis. In the whole 85 cases, 34 cases were injured because of fall, 51 cases because of car accident, and 16 cases are combined dislocation of the shoulder joint. Divide these cases into group A(internal fixation with cannulated screw)and group B(internal fixation with anatomical plate) according to the different internal fixation methods. Group A has 38 cases, involving 23 cases of male and 15 cases of female with age from 23 to 69(averagely 52.50 ±9.04 years) years, and in this group there are 7cases are combined dislocation of the shoulder joint. Group B has 47 cases, involving 27 cases of male and 20 cases of female with age from 38 to 67(averagely 50.79 ±6.99years) years, and in this group there are 9 cases are combined dislocation of the shoulder joint. About the fracture types, in group A there are 20 cases of split fracture and 18 cases of avulsion fracture, and in group B there are 25 cases of split fracture and 22 cases of avulsion fracture. Collection and record the length of the surgical incision,operation time, bleeding volume during the operation, the fracture healing time,postoperative complications and postoperative shoulder joint function in the cases data of these two group, and process the recorded data with statistical software SPSS19.0, to compare the general effect of the two different internal fixation methods in treating the fracture of the greater tuberosity of humerus.Results 85 patients received a 12 ~ 24 months long’s follow-up, no patients had complications, such as postoperative wound infection, nonunion and internal fixation broken. 4 patients turn up subacromial impingement syndrome, but after removed the internal fixation when fracture is healing, all symptoms were disappeared. In split fracture of the greater tuberosity of humerus, comparing the incision length, the operative time, the bleeding volume during the operation, the fracture healing time, postoperative shoulder joint function and excellent rate of the two group, we can find that the differences have statistical significance(P < 0.05). In avulsion fracture of the greater tuberosity of humerus, comparing the incision length, the operative time and the bleedingvolume during the operation, we can find that the differences also have statistical significance(P < 0.05), but comparing the fracture healing time, postoperative shoulder joint function and excellent rate of the two group, the differences have no statistical significance(P > 0.05).Conclusions Cannulated screw and anatomical plate are both effective internal fixation methods for treating the fracture of the greater tuberosity of humerus.When treating the fracture of the greater tuberosity of humerus using open reduction and internal fixation, the clinical effects of the anatomical plate internal fixation is better than the cannulated screw internal fixation, thus anatomical plate internal fixation is the first choice. When treating the avulsion fracture of the greater tuberosity of humerus, cannulated screw internal fixation and anatomical plate internal fixation are both effective, and the clinical effects of these two internal fixation methods are close, there is no obvious differences. |
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