Locking Plate Combined With Fibular Allogeneic Bone Marrow Transplantation In The Treatment Of Comminuted Proximal Humeral Fractures In The Elderly

Objective:Locking plate internal fixation is a common surgical method for the treatment of comminuted proximal humeral fractures in the elderly,but the postoperative complications are still common,affecting the daily life of patients.The purpose of this study is to compare the clinical efficacy of locking plate combined with allogeneic fibular bone marrow transplantation and simple locking plate internal fixation in the treatment of elderly neer three and four part proximal humeral fractures,and analyze the clinical application of locking plate combined with allogeneic fibular bone marrow transplantation in the treatment of elderly patients with comminuted proximal humeral fractures.method:From June 2017 to December 2020,62 elderly patients with proximal humeral fractures who were hospitalized in Shantou Central Hospital for surgical treatment were retrospective analyzed.Conform to the standard of patients divided into two groups,group A as control group,group B as observation group.The operation was performed by the same chief doctor and his team.Through outpatient follow-up data and imaging evaluation,the operation time,intraoperative bleeding,total complication rate,imaging evaluation,pain degree,shoulder joint function and other data of the two groups were compared and analyzed.result:1.There was no statistical difference between the two groups in the follow-up time,age,gender,shoulder injury mechanism fracture,Neer classification,injury and operation time,operation duration,intraoperative bleeding(P>0.05).2.There were no significant differences between the two groups in preoperative neck stem Angle,the first review after the operation and the relative plate height of the humeral head(P >0.05).The humeral neck stem Angle and the relative plate height of the humeral head in the last review after 1 year of postoperative follow-up in group B were all higher than that in group A(P< 0.05).The change value of neck shaft Angle and the loss of humeral head relative plate height were all decreased compared with group A(P < 0.05),with statistical differences.The healing time of fracture in group B was shorter than that in group A(P < 0.05).3.Preoperative VAS and CMS in 2 groups were not statistically significant(P > 0.05).VAS score and DASH score in group A were higher than those in group B,and CMS score was lower than those in group B,with statistical significance(P < 0.05).4.The total complication rate of group A was higher than that of group B(P < 0.05)。Conclusion:Proximal humeral locking plate combined with allogeneic fibula intramedullary support has become an important treatment.This method can strengthen the humeral head support,prevent the humeral head varus displacement,reduce the internal fixation failure and screw out of the articular surface and other complications,reduce pain,and accelerate the recovery of shoulder joint function.In this study,the patients with proximal humerus locking plate combined with allograft fibula intramedullary transplantation fixation technology were compared with the patients with simple locking plate fixation treatment.There were some advantages in imaging evaluation,pain degree,shoulder joint function recovery,complications and fracture healing time,while there was no difference in operation time and intraoperative bleeding.