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ORIGINAL RESEARCH article

Front. Surg.
Sec. Orthopedic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1472054
This article is part of the Research Topic Diagnosis and Treatment of Osteoporotic Fractures: Advances, Challenges, and Future Perspectives View all articles

Comparison of clinical efficacy of different internal fixation methods in elderly patients with osteoporotic fractures of proximal humerus

Provisionally accepted
Wang Jianchuan Wang Jianchuan 1,2wang tienan wang tienan 1*qin song qin song 1*wang zongpu wang zongpu 1*Guan tianmin Guan tianmin 3*
  • 1 Affiliated Zhongshan Hospital of Dalian University, Dalian, China
  • 2 Affiliated Zhongshan Hospital of Guangdong Medical University, Zhongshan, Guangdong Province, China
  • 3 School of Mechanical Engineering, Dalian Jiaotong University, Dalian, Liaoning Province, China

The final, formatted version of the article will be published soon.

    To compare the efficacy of three treatment methods for elderly patients with osteoporotic proximal humerus fractures: proximal humerus locking plate (PHILOS) combined with calcium sulfate injection, PHILOS plate alone, and artificial hemi-shoulder joint replacement. Methods:The clinical data of 48 elderly patients with osteoporotic proximal humerus fractures admitted to the Shoulder and Elbow Surgery Department of Zhongshan Hospital Affiliated with Dalian University from February 2018 to August 2021 were retrospectively analyzed.patients comprised 18 males and 30 females, with a mean age of (68.6 ± 5.8) years.48 patients were divided into three groups based on their treatment methods:Group A: 16 patients treated with PHILOS plate combined with calcium sulfate injection.Group B: 16 patients treated with the PHILOS plate alone.Group C: 16 patients treated with artificial hemi-shoulder joint replacement. Key parameters such as operation time, blood loss, incision length, operation cost, and shoulder joint motion at the final follow-up were recorded and compared. Shoulder joint function was evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS) for pain, University of California Shoulder Joint Score (UCLA), and Brief Shoulder Function Test (SST).Results:There were no statistically significant differences in the preoperative general data between the three groups (P > 0.05), indicating comparability.There was no significant difference in operation time, blood loss, and incision length among Groups A, B, and C (P > 0.05). However, Group C had significantly higher operation costs compared to the other two groups (P < 0.05).At the final follow-up, there were no significant differences in shoulder flexion and rotation among the three groups (P > 0.05). However, a statistically significant difference in abduction was observed between Group A and Group C (P < 0.05).No significant differences were found in ASES, VAS, UCLA, and SST scores among the three groups at the last follow-up (P > 0.05).All three surgical methods are effective in treating elderly osteoporotic proximal humerus fractures, as they significantly alleviate pain and restore joint function. However, the use of a PHILOS plate combined with calcium sulfate injection (Group A) is particularly effective, demonstrating reliable clinical efficacy with fewer complications.

    Keywords: Fracture of proximal humerus in elderly, Osteoporosis, Internal fixation with plates, Half-shoulder joint replacement, Calcium Sulfate

    Received: 28 Jul 2024; Accepted: 20 Dec 2024.

    Copyright: © 2024 Jianchuan, tienan, song, zongpu and tianmin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    wang tienan, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
    qin song, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
    wang zongpu, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
    Guan tianmin, School of Mechanical Engineering, Dalian Jiaotong University, Dalian, 116028, Liaoning Province, China

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