Objective To explore the clinical effect of locking plate fixation of the proximal humeral fractures.
Methods Total 32 cases of proximal humerus fracture treated with locking plate in orthopedics department of the First People's Hospital of Chuzhou from December, 2013 to June, 2016. The block anesthesia or general anesthesia was carried out during the operation. Via intermuscular space between pectoralis major and deltoid muscle, deltoid muscle partial insertions were loosen, and the end of the fracture was exposed, the large and small nodules and long head tendons of the biceps brachii were identified. The suture stitched in the joint of the tendon and bone of the size nodules was used as a traction line. After the fracture reduction is satisfactory, the proximal locking plate of the humerus was placed. After the operation, the function of the shoulder joint function was individualized according to the type of fracture and the fixation of the bone. Function, motion range and anatomical position were evaluated by Neer scoring system.
Results The X-ray film was reviewed after the operation:31 patients were satisfied with fracture reduction, and one case was not well restored. All 32 patients were followed up for 10 to 16 months. The fracture healing time was 4-8 months. All 32 patients had bone healing, 31 patients were satisfactory reduction and one patient had poor reposition. There was no shoulder peak impact, no reset loss, no humeral head necrosis, no incision infection, no screw loose and wear the humeral head. The function of shoulder joint was evaluated by the Neer scoring method which postoperative pain (35 points), function (30 points), motion range (25 points), and anatomical position (10 points). Twenty-eight cases got excellent result, 2 cases good and 2 case poor.
Conclusion The locking plate inserted into the path through the pectoralis major deltoid muscle for proximal humerus fractures has the advantages of fixed firmness, good postoperative function and few complications.
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