| Background:Proximal humerus fracture is one of the commonest injuries which is sustained by elderly people.The optimal best treatment for patients with displaced fractures of the proximal humerus,especially elderly patients with osteoporosis.is still controversial.For the 3-and 4-part fractures according to the Neer’s classification,there is an ongoing trend towards more frequent surgical interventions with modern locking compression plates.The decline of elderly patient bone mass and strength,increases the risk of failure of fixation surgery,or sometime even seriously affect the normal life order of the elderly people,resulting in the serious decline of their life quality.Objective:To compare,analyze and evaluate the clinical efficacy of the combination of locking compression plate and anti-osteoporosis drug with the locking compression plate only for the patients with elderly osteoporotic proximal humerus fractures.Methods:This is a randomized controlled study,single blinded,conducted at department of traumatology,second affiliated Hospital of Kunming Medical University.Duration of study was from September 2017 to September 2019.Total of 74 patients(16 males and 58 females)with complex proximal humerus fracture were enrolled into the study.Clinical case records and operative notes were used for the information of the patient and self-made pretested form was used for documentation.The total patients were divided into two groups based on the treatment option:37 patients under went Proximal humeral compression plate only treatment and remaining 37 patients had undergone Proximal humeral compression plate with anti-osteoporosis medicine for treatment.Lost to follow up rate was 2.70%.Various demographic,clinical,surgical complications parameters(age,sex,injury side,fracture cause,comorbidities,classification,duration from injury to surgery,length of hospital stay,operative time,follow-up period,healing time,serum β-ctx,serum vitamin D3,constant score)were compared using SPSS-24 software and frequency,percentage,mean,SD,t and P value are basic statistical tolls used whenever applicable.Results:Mean age of patient were 61.7±9.0 in Proximal humerus compression plate only group and 63.1±8.2 years in Proximal humerus compression plate with anti-osteoporosis medicine group(p=0.49).Patient with Proximal humerus compression plate with anti-osteoporosis medicine group demonstrate shorter healing time,higher serum vitamin D3,lower serum β-ctx level and higher constant score than Proximal humerus compression plate only group(P<0.001),making it statistically significant.There was no significant difference regarding age,gender,side of injury,hospital stay,follow up period,and duration from injury to surgery(P>0.05).Two patients of Proximal humerus compression plate only group had varus collapse whereas one had delayed callus formation and one had AVN.Further in Proximal humerus compression plate with anti-osteoporosis medicine group none patient had surgical complication.Conclusion:The treatment efficacy of the combination of locking plate and anti-osteoporosis drug than only locking compression plate treatment for elderly osteoporotic proximal humeral fractures is more advantageous,safest and precise,which is worth being applied in clinical practice. |
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