G Li1, W F Wei1, X Liu1, T Yang1. 1. Department of Trauma Orthopedics, Tianjin Hospital, Tianjin 300210, China.
Abstract
Objective: To compare the effect of intramedullary nail and locking plate in the treatment of proximal humeral fractures in the elderly. Methods: A total of 37 elderly patients with proximal humeral fractures were selected from April 2016 to June 2018 in Tianjin Hospital, including 13 males and 24 females, aged (66±5) years. The patients were divided into observation group (17 cases) and control group (20 cases) according to the random number table, and were treated with multiloc intramedullary nail and locking plate respectively. The operation time, blood loss, healing time of fractures, visual analogue scale of pain, Neer shoulder function score were recored and compared between the two groups. The data were compared with t test between the two groups. Results: The operation time of the observation group was shorter than that of the control group ((72±7) min vs (89±9) min, t=6.365, P<0.05); the intraoperative bleeding volume was lower than that of the control group ((56±6) ml vs (74±8) ml, t=7.923, P<0.05). The superior rate of shoulder function was 94.1%(16/17) in the observation group and 90.0%(18/20) in the control group (χ(2)=0.209, P>0.05). The VAS score of the observation group was lower than that of the control group on the first day after operation (t=4.706, P<0.05); the Neer shoulder function score of the observation group was higher than that of the control group on the sixth month after operation (81±8 vs 76±8, t=2.156, P<0.05). Six months after the operation, the valgus angle (19.21°±2.88°) of the observation group was larger than that of the control group (16.32°±2.63°, t=3.189, P<0.05), the humeral head varus angle (3.57°±0.47°), the humeral neck stem angle (139°±10°) was smaller than that of the others (5.24°±1.26°), (146°±13°) (t=5.159, 2.258, both P<0.05). There was no significant difference in shoulder function score and complication rate 12 months after operation between the two groups (both P>0.05). Conclusion: Both intramedullary nailing and locking plate can achieve better results in the treatment of proximal humeral fractures in the elderly, but the operation time of intramedullary nailing is shorter, the pain after operation is lighter and the recovery is faster.
RCT Entities:
Objective: To compare the effect of intramedullary nail and locking plate in the treatment of proximal humeral fractures in the elderly. Methods: A total of 37 elderly patients with proximal humeral fractures were selected from April 2016 to June 2018 in Tianjin Hospital, including 13 males and 24 females, aged (66±5) years. The patients were divided into observation group (17 cases) and control group (20 cases) according to the random number table, and were treated with multiloc intramedullary nail and locking plate respectively. The operation time, blood loss, healing time of fractures, visual analogue scale of pain, Neer shoulder function score were recored and compared between the two groups. The data were compared with t test between the two groups. Results: The operation time of the observation group was shorter than that of the control group ((72±7) min vs (89±9) min, t=6.365, P<0.05); the intraoperative bleeding volume was lower than that of the control group ((56±6) ml vs (74±8) ml, t=7.923, P<0.05). The superior rate of shoulder function was 94.1%(16/17) in the observation group and 90.0%(18/20) in the control group (χ(2)=0.209, P>0.05). The VAS score of the observation group was lower than that of the control group on the first day after operation (t=4.706, P<0.05); the Neer shoulder function score of the observation group was higher than that of the control group on the sixth month after operation (81±8 vs 76±8, t=2.156, P<0.05). Six months after the operation, the valgus angle (19.21°±2.88°) of the observation group was larger than that of the control group (16.32°±2.63°, t=3.189, P<0.05), the humeral head varus angle (3.57°±0.47°), the humeral neck stem angle (139°±10°) was smaller than that of the others (5.24°±1.26°), (146°±13°) (t=5.159, 2.258, both P<0.05). There was no significant difference in shoulder function score and complication rate 12 months after operation between the two groups (both P>0.05). Conclusion: Both intramedullary nailing and locking plate can achieve better results in the treatment of proximal humeral fractures in the elderly, but the operation time of intramedullary nailing is shorter, the pain after operation is lighter and the recovery is faster.