Comparison Of Therapeutic Effects Of Interlocking Intramedullary Nail And Locking Plate Based On "Equal Emphasis On Muscles And Bones" In The Treatment Of Neer Type Ⅱ Fracture Of Humerus

Objective:To compare the efficacy of intramedullary nail and locking plate in the treatment of Neer II Proximal Humeral Fractures based on the theory of“equal emphasis on muscles and bones”.Methods:The data of patients with Neer type II fracture of humerus who visited the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2019 to June 2021 were collected.The incision length,operation time and intraoperative blood loss were recorded,respectively;the VAS pain simulation score was recorded on the 1st and 7th day after operation;the patients were asked to have reexamination on time after discharge;and the Constant-Murley score was recorded at the 6th week,3rd month,6th month and 9th month after operation;the number of cases with postoperative complications and the healing time of fracture were recorded.Results:1.A total of 25 patients in the intramedullary nail group were included,including 8 male patients and 17 female patients,with an average age of 60.20 ± 9.12 years,14 cases on the left side,11 cases on the right side,18 cases of falls,5 cases of traffic injuries,and 2 cases of falls from height;23 patients in the plate group,including 8 male patients and15 female patients,with an average age of 61.71±10.49 years,13 cases on the left side,10 cases on the right side,18 cases of falls,4 cases of traffic injuries,and 1 case of falls from height.2.In terms of incision length,operation time and intraoperative blood loss,the intramedullary nail group was superior to the locking plate group,and the difference between the two groups had statistical significance(P<0.05).3.In terms of fracture healing time,the intramedullary nail group was superior to the locking plate group,and the difference between the two groups was statistically significant(P<0.05).4.In terms of VAS score,the intramedullary nail group was superior to the plate group on postoperative days 1 and 7,and the difference between the two groups was statistically significant(P<0.05),while the VAS score at postoperative month 1 was not significantly different between the two groups(P>0.05).5.In terms of Constant-Murley score,at the 6th week,3rd month and 6th month after operation,the intramedullary nail group was superior to the locking plate group,and the difference between the two groups had statistical significance(P<0.05),while the difference between the two groups at 9 months after operation had no statistical significance(P>0.05).6.There were 5 cases of complications in the locking plate group,including 2 cases of delayed fracture healing and 3 cases of pain around the shoulder joint,2 cases of complications in the intramedullary nail group,including 1 case of pain around the shoulder and 1 case of delayed fracture healing.Conclusion:1.By comparison,interlocking intramedullary nail,compared with locking plate fixation,is more in line with the principle of “Equal Emphasis on Muscles and Bones”,has obvious advantages in surgical time and surgical trauma,has less damage to the soft tissues around the shoulder,can significantly reduce the postoperative pain around the shoulder,and is more conducive to early functional exercise.2.Overall,the two fixation methods of interlocking intramedullary nail and locking plate can achieve satisfactory therapeutic effect in the treatment of Neer type II fracture of humerus,and there is no significant difference between the two groups during follow-up.Both treatment methods can be applied in clinical treatment.