A Comparative Analysis Of Bone Cememt Or Allogeneic Bone With Locking Proximal Humerus Plate Treating In Humerus Surgical Neck Fracture Of Elderly Patients

Objective: Compare and analyse two kinds of Operation mode bonecement or allogeneic bone strips with proximal humeral locking plate inthe treatment of the surgical neck fracture of the humerus of elderlypatients, evaluating two Operation modes for the effects of early andlong-term shoulder function of postoperative patients.Methods: Collect the patients of elderly surgical neck fracture of thehumerus which were treated in the orthopaedic of the second hospital ofjilin university from January2008to April2010, total32cases, including15males and17females. The32patients were randomly divided into thebone cement group (A group) and allogeneic bone group(B group),theA group including17cases,the B group including15cases.all patientswere treated with the anterior shoulder approach for open reduction andselected proximal humeral locking plate for internal fixation. Group Awere selected bone cement to fill the bone defect; Group B were selectedallogeneic bone to fill. We evaluated short-term and long-term shoulderfunction situation of postoperative patients by the Neer shoulder functionscores.Results:32patients all geted an effective follow-up which period were24to30months, with an average of27months. By the regularreexamination of anteroposterior film of the shoulder joint of A, Bpostoperative, we use the standard of fracture healing to confirm that twogroups(A and B) of patients were both healed well, no late healed,nonunion or caput humeri necrosis. The shoulder joint function recoveryof patients were evaluated by Neer shoulder function score.After3months of follow-up, The A: excellent in9cases, good in4cases,middlein3cases, poor in1case, the fine/excellent rate of76.5%; The B:excellent in3cases,good in3cases, middle in six cases, and poor in3cases, the fine/excellent rate of40.0%; After24months of follow-up, TheA: excellent in13cases, good in3cases, middle in1case and poor in0cases, the fine/excellent rate of94.1%; The B: excellent in10cases,good in4cases, midlle in1, poor in0cases, the fine/excellent rate of93.3%.Conclusion: According to the Neer shoulder function score, after3months of follow-up, the fine/excellent rate of A was76.5%, thefine/excellent rate of B is only40.0%. Group A was higher than that ofgroup B, there are significant differences in the comparison of thefine/excellent rate(P<0.05);24months of follow-up, the fine/excellentrate of A was94.1%, the fine/excellent rate of B is only93.3%, Group Awas better than that of group B, there are no significant differences in thecomparison of the fine/excellent rate (P＞0.05). Therefore, The patients of elderly fracture of surgical neck of humerus used the way that bonecement combined with proximal humeral locking plate, only early fixed,and long-term effect was good.The patients of elderly fracture of surgical neck of humerus, inparticular, is more associated with osteoporosis in female patients. theprinciples of the modus operandi is a good anatomical reduction and rigidinternal fixation and early functional exercise. The selection of bonecement combined with proximal humeral locking plate was used in thetreatment of the patients of elderly fracture of surgical neck of humerus,steel plate by screws multi-angle multi-dimensional stereoscopic werefixed in the proximal humerus, given fractures reliable extramedullaryfixation; Bone cement used its good biocompatibility andosteoconductivity, after solidification, which combining the screwsformed a strong intramedullary connection. The two both formed averitable "double plate fixation” in medullary cavity inside and outsideafter fracture fixation. Such a operation mode maked the early fractureachieve good stability, providing a solid guarantee for the earlierfunctional exercise of shoulder joint of elderly patients.