Abstract:

BACKGROUND: Locking proximal humerus plate (LPHP) fixation follows the principles of elastic biological internal fixation. It is suitable for the youth comminuted fracture and aged osteoporotic fracture.
OBJECTIVE: To observe the clinical effect of LPHP combined with calcium sulfate (OsteoSet) and anti-osteoporosis treatment for proximal humeral unstable fracture of aged patients. 
METHODS: Twenty-six cases of aged proximal humeral fractures were treated with type classification according to Neer classification criteria: 17 cases with two-part fracture, 7 cases with three-part fracture and two cases with four-part fracture. All the patients were treated with anti-osteoporosis treatment which was detected by X-ray and CT of shoulders and radiographic absorptiometry of phalanges bone mineral density. At 5-10 days after fracture, LPHP internal fixation combined with OsteoSet were used for the treatment of proximal humeral unstable fracture.
RESULTS AND CONCLUSION: Bone mass of 26 patients was decreased 4% (1 case) by radiographic absorptiometry detection and osteoporosis was 96% preoperatively. All the patients were follow-by over 12 months postoperatively. The Neer score showed that the good-excellent rate was 94% in the two-part fracture, and 67% in the three or four-part fracture. There were no incision infection, disunion of internal fixation and humeral head necrosis happened, all the fractures had united in 3.8 months (from 2.5 to 7 months). It is indicated that: ①The clinical effect of LPHP combined with OsteoSet and anti-osteoporosis treatment on proximal humeral unstable fracture of aged patients is satisfactory. ②Radiographic absorptiometry of phalanges bone mineral density detection is beneficial to the screening for fracture patients osteoporosis preoperatively.