[Case-control study on locking plates fixation for the treatment of Neer 3-and 4-part proximal humerus fractures].

Objective:To compare therapeutic effects of locking plates for the treatment of Neer 3 and 4 part proximal humerus fractures. Methods:From January 2009 to June 2011,64 patients with Neer 3 and 4 part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3 part group including 16 males and 23 females,with an average age of(55.12±12.52)years old;and 25 patients in the 4 part fractures group including 9 males and 16 females,with an average age of(57.92±13.14) years old. The American Shoulder and Elbow Surgeons score(ASES),visual analogue scale(VAS)and complications were documented for analysis before and after treatment. Results:All the patients had incision healing at the first stage. All the patients were followed up,and the duration ranged from 12 to 30 months,with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3 part fractures group with regard to the ASES(76.14±14.10 in the 3 part fractures group vs. 65.93±11.82 in the 4 part fractures group,P0.05). Moreover,a statistical difference(P0.05) was observed regarding the VAS pain score(2.12±1.63 in the 3 part fractures group vs. 3.90±2.21 in the 4 part fractures group). For the complications rate,no statistical difference was noted between 3 part fractures group and 4 part fractures group(20.51% vs. 36.00%). Conclusion:The clinical outcomes of the 3 part proximal humerus fractures is better than the 4 part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction,stable fixation,proper screws and plate placement,and reasonable functional exercise postoperative.