%A She Rongfeng, Zhang Yi, Wang Yuanzheng, Zhang Bin, Chen Peng, Huang Qixiang %T
A novel cement-reinforced screw combined with locking plate
fixation versus humeral head
arthroplasty in the treatment of osteoporotic fractures of the proximal humerus
BACKGROUND: To solve the complications such as screw cut-out, loosening, and
insufficient holding force that may occur during internal fixation of
osteoporotic fractures, a new cement-reinforced screw combined with PHILOS
plate is currently used to treat osteoporotic fracture of the proximal humerus.
However, there are few reports on the clinical efficacy of this technique in
the treatment of osteoporotic fractures of the proximal humerus in China.
OBJECTIVE: To compare the clinical efficacy of
a novel cement-reinforced screw combined with locking plate fixation and
artificial humeral head replacement in the treatment of osteoporotic fractures
of the proximal humerus.
METHODS: Twenty-two patients with
osteoporotic fractures of the proximal humerus admitted to at Guizhou
Provincial People’s Hospital from February 2017 to March 2019 were enrolled,
including 8 males and 14 females, aged 68-88 years. Ten patients underwent open reduction using new
cement-reinforced screws combined with locking plate internal fixation
(internal fixation group), and 12 patients underwent humeral head arthroplasty
(humeral head arthroplasty group). The operation time, intraoperative blood
loss, and intraoperative and postoperative complications were compared. The
Visual Analogue Scale and Constant scores of the shoulder joint were detected
at 6 months after surgery. All patients received a postoperative
anti-osteoporosis treatment. The study was approved by the Ethics Committee of
Guizhou Provincial People’s Hospital, approval No. 2017(02).
RESULTS AND CONCLUSION: (1) Twenty-two patients
were followed up for 6-15 months, an average of (9.0±1.6) months. (2) No toxicity reaction of
bone cement or embolism occurred in both groups. One case of postoperative shoulder
stiffness occurred in the internal fixation group. There were no complications
in both groups, such as incision infection, heterotopic ossification, delayed
healing, and screw cut-out. (3) The operation time and intraoperative blood
loss in the internal fixation group were significantly less than those in the
humeral head arthroplasty group (P < 0.05). (4) The Visual Analogue Scale and the excellent and good rate of
Constant scores of the shoulder joint at 6 months after surgery showed no
significant differences between two groups (P > 0.05). (5) In summary, the novel cement-reinforced screw technique
combined with locking plate internal fixation has similar clinical efficacy
with humeral head arthroplasty. Therefore, this new technique is an alternative
internal fixation method for some patients scheduled for shoulder joint
arthroplasty.