Comparative analysis of operative treatment of fractures of the proximal humerus using two different surgical techniques.

Srđan Ninković, Nataša Janjić, Nikola Vukosav, Milan Milinkov, Oliver Dulić, Predrag Rašović
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Abstract

Objective: The purpose of this study was to examine the surgical treatment of two-part and three-part proximal humerus fractures utilizing two approaches.

Method: Study involved a total of 40 individuals. Twenty patients were treated with plates and screws and 20 with intramedullary locking nail osteosynthesis. We created 10 pairs of patients that were matched in age, gender, and fracture type, with the sole difference being the osteosynthetic material used. The mean follow-up was 4 years (1-9 years). We evaluated the results of treatment using Constant's scoring scale.

Results: The mean value of Constant's scoring scale was 78.05 for patients treated with plates and screws and 67.55 for those treated with intramedullary stabilization. There was no statistically significant difference between the groups nor were there statistically significant differences in post-operative range of motion (ROM).

Conclusions: The results of Constant's scoring scale were higher for patients whose fractures were stabilized with a plate and screws. The same group of patients had a higher degree of mobility and better ROM. Even while there was a general tendency toward better outcomes when using plates and screws for fixation, there was no indication as to which surgical technique offers the best results.

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使用两种不同手术技术对肱骨近端骨折进行手术治疗的比较分析。
研究目的本研究旨在探讨采用两种方法对肱骨近端两部分和三部分骨折进行手术治疗的情况:研究共涉及 40 名患者。20名患者采用钢板和螺钉治疗,20名患者采用髓内锁钉骨合成术治疗。我们创建了10对年龄、性别和骨折类型匹配的患者,唯一的区别是使用的骨合成材料。平均随访时间为 4 年(1-9 年)。我们使用康斯坦茨评分标准对治疗效果进行了评估:结果:使用钢板和螺钉治疗的患者康斯坦茨评分量表的平均值为 78.05,使用髓内稳定治疗的患者为 67.55。组间差异无统计学意义,术后活动范围(ROM)差异也无统计学意义:结论:使用钢板和螺钉稳定骨折的患者康斯坦茨评分量表结果更高。同组患者的活动度更高,活动范围更好。尽管使用钢板和螺钉固定的效果普遍较好,但没有迹象表明哪种手术技术的效果最好。
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