The clinical efficacy of locking plate versus humeral head prosthesis for treatment of comminuted proximal humeral fractures

[Objective]To comparate and analyse the short-term clinical efficacy of locking plates and humeral head prosthesis for proximal humeral complicated fractures.[Method]The retrospective data of 61 cases deal with locking plate or humeral head prosthesis replacement for treatment of comminuted proximal humeral fractures were collected from January 2009 to June 2011 in our hospital.According to Neer classification,they were part three and part four fractures.Deal with locking plate(n=35),part three fractures of proximal humeral were(n=23)and part four(n=12),Deal with humeral head prosthesis replacement(n=26),part three fractures ofproximal humeral were(n=5) and part four(n=21).The operative time,blood loss and a one-time cost of hospitalization were contrasted between two groups,and the curative effect was also evaluated according to Neer scoring system.[Result] In the internal fixation group: the mean operative time was 60 ± 5 min,the mean intraoperative blood loss was 300 ± 10ml,and the disposable hospital average cost was $ 37 940±3 500.In the replacement group: the mean operative time was 50 ± 5 min,the mean intraoperative blood loss was 350 ± 20ml,and the disposable hospital average cost was $ 38 850±4 800.The follow up was ranging from 12 to 36 months(mean,20.5months).Assessed by Neer scoring system,The rate of excellent and good results was 86.2% in locking plate group,no significance was found to humeral head prosthesis group 90%(P0.05).[Conclusion]Locking plate and humeral head prosthesis in the treatment of proximal humerus comminuted fracture were similar in the operative time,intraoperative blood,disposable hospital average cost,and both of them were able to achieve a satisfactory clinical outcome.Two choics of surgical approach depend on the screening of the correct indications.The locking plate fixation is the best option to the person who is young and is able to reach intraoperative repositioning.The humeral head prosthesis is the best choice to the old person with severely comminuted proximal humerus fractures.