Efficacy of artificial humeral head replacement versus locking plate internal fixation in the treatment of comminuted proximal humeral fractures in older adult patients
10.3760/cma.j.cn341190-20250311-00310
- VernacularTitle:人工肱骨头置换术与锁定钢板治疗老年肱骨近端粉碎性骨折的疗效比较
- Author:
Junping WANG
1
;
Dongdong WANG
1
;
Youli WU
1
;
Donghai LI
1
;
Xuelian ZHANG
1
Author Information
1. 淮南新华医疗集团北方医院骨科，淮南 232052
- Publication Type:Journal Article
- Keywords:
Humeral fractures;
Fractures,comminuted;
Arthroplasty,replacement;
Fracture fixation;
Treatment outcome;
Range of motion,articular;
External fixators
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(8):1210-1214
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of artificial humeral head replacement versus locking plate internal fixation in the treatment of comminuted proximal humeral fractures in older adult patients. Methods:A total of 30 older adult patients with proximal humeral comminuted fractures, admitted to Beifang Hospital, Huainan Xinhua Medical Group from January 2022 to December 2024, were included in this study. A prospective randomized controlled study design was used. The patients were divided into an observation group and a control group using a random number table method, with 15 patients in each group. The observation group underwent artificial humeral head replacement surgery, while the control group received internal fixation with a proximal humeral locking plate. Clinical treatment outcomes, shoulder joint function recovery, and complications were observed and compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group [(182.24 ± 24.36) mL vs. (245.17 ± 46.08) mL]. The surgery duration [(71.84 ± 7.52) minutes vs. (93.67 ± 12.50) minutes] and hospital stay [(11.37 ± 1.89) days vs. (13.52 ± 2.67) days] were also significantly shorter in the observation group compared with the control group ( t = 4.68, 5.80, 2.55, all P < 0.05). The range of motion in the shoulder joint was greater in the observation group compared with the control group [forward elevation: (94.47 ± 7.66) ° vs. (86.14 ± 5.15) °, external rotation: (61.35 ± 6.57) ° vs. (52.40 ± 4.82) °, and internal rotation: (74.35 ± 4.80) ° vs. (62.76 ± 3.59) °]. The total Constant-Murley score was higher in the observation group [(92.91 ± 10.58) vs. (76.29 ± 7.48)], and the rate of excellent recovery of shoulder function was also higher in the observation group [73.33% (11/15) vs. 53.33% (8/15)] compared with the control group. The incidence of complications was lower in the observation group [6.66% (1/15) vs. 33.33% (5/15)] compared with the control group. All differences were statistically significant ( t = 3.50, 4.25, 7.49, 4.97, χ2 = 4.12, 5.12, all P < 0.05). Conclusions:For older adult patients with severe osteoporosis or irreparable proximal humeral comminuted fractures, artificial humeral head replacement yields more favorable outcomes compared with locking plate internal fixation, resulting in a better recovery of shoulder joint function.
