Comparison of locking plate and anatomical type plate in the treatment of proximal humeral fracture.

[Objective]To investigate the therapeutic effect on proximal humeral fracture for two kinds of treatment methods and make theoretical analysis to offer basis on choosing the proper treatment method in clinic.[Methods]The clinical and radiological records of 115 patients with proximal humeral fracture for two kinds of different treatment were reviewed:open reduction and internal fixation with locking plate(53 cases,group LP) and anatomical type plate(62 cases,group AP) from January 2005 to January 2008.The bleeding volume,union of fracture time,incidence of complications,total cost of hospitalization and Neer scores(functional outcome was assessed with the Neer scores) were compared in different methods.[Results]All the patients were followed up for above 6 months.Compared to group AP,Group LP was significantly lower in the bleeding volume(225±25) ml vs.(362±29) ml,the incidence of complications 1.89% vs.12.9%(P0.01),and higher rate of the Neer Score 96.2% vs.82.3%(P0.01).In term of average hospital costs,LP group(19 429±344) RMB was higher than AP group(12 485±257) RMB(P0.01).But the union of fracture time were not statistically significant between the two groups(P0.05).[Conclusion]The clinical results of using locking plate in proximal humeral fracture were found to be satisfactory,specially for osteoporotic fractures.Despite more spending,it has the advantage of reliable fixation,less surgical trauma and less complication,should be cared for and emphasized in clinic.