Abstract:

BACKGROUND: Type Neer Ⅲ and Ⅳ proximal humeral fractures are difficult to treat.
OBJECTIVE: To compare the clinical effects of humeral head replacement and locking plate in treating proximal humerus comminuted fractures. 
METHODS: The effects of 26 cases undergoing humeral head replacement in treating proximal humerus comminuted fractures from June 2004 to August 2006 were analyzed retrospectively. The 26 cases were hospitalized and treated with humeral head replacement. Patients treated with locking plate or routine internal fixation methods were retrieved and served as control. Neer evaluation was used to compare the efficacy and complications.
RESULTS AND CONCLUSION: All 26 cases were followed-up from 11 to 36 months with an average of 24 months. According to the standard of Neer, there were 11 cases of excellent, 13 of satisfied, and 2 of unsatisfied. There were no significant differences in locking plate group (P > 0.05), but superior over conventional fixation group (P < 0.05). The complications included pain in 2 cases of humeral head replacement group; 6 humeral head necrosis and 3 pain in locking plate group; 1 infection, 4 acromion impingement, 6 humeral head necrosis and 6 pain. Results showed that under rigorous operative indications, the operation of humeral head replacement can alleviate or eliminate patients’ pain and help restore the function and stability of the shoulder joint.