Effects of medial column positive and negative support on proximal humerus fracture with locking plate

Objectives To determine the positive and negative supports by measuring neck shaft angle of the humerus, to analyze the correlation between the positive and negative supports of the medial column and the curative effect of the proximal humerus fracture after locking plate fixation.

Methods To determine the positive and negative supports by measuring neck shaft angle of the humerus, to analyze the correlation between the positive and negative supports of the medial column and the curative effect of the proximal humerus fracture after locking plate fixation. Methods: Retrospective analysis of medical records of 128 patients with proximal humerus fracture treated with proximal humerus anatomic locking plate from June 2016 to August 2019. All cases were divided into positive support and negative support according to the proximal medial cortical support of the humerus. By measuring the change of the proximal humerus angle of the ipsilateral humerus at the time of postoperative follow-up and evaluating the function of the shoulder joint, the role of positive support and negative support in the maintenance of fracture reduction and functional recovery of patients was compared and analyzed.

Results and Conclusion Results: 128 patients were followed up for 10-18 months, with an average of 13 months. There were 65 cases in the positive support group and 63 cases in the negative support group. By the last follow-up, all patients had solid bone healing. The average loss of the proximal humerus neck angle in the positive support group was (12 ± 1.8) °, and the average loss of the proximal humerus neck angle in the negative support group was (18 ± 2.3) °, which was significantly higher than the positive support group. In the positive support group, the Neer score was 57, excellent, 2 good, 3 fair, and 3 poor, with a good and good rate of 90.8%. In the negative support group, 50 excellent, 4 good, 4 fair, and 5 poor. The excellent and good rate is 85.7%. In the positive support group (65 cases), 1 case of the screw penetrated the articular surface, 1 case of the screw loosened, and 1 case of the screw penetration of the articular surface was re-operated to remove or replace the screw. In the negative support group (63 cases), 3 cases of screws penetrated the articular surface, 2 cases of screws appeared loose, and 3 cases of screws penetrated the articular surface were re-operated to remove or replace the screws.

Conclusion: The medial support after the proximal humerus fracture after locking plate fixation is very important for the curative effect. Positive support is more effective than negative support by improving the mechanical stability of the medial column and maintaining the reduction.

Stichwörter medial column; proximal humerus fracture;locking plate; neck shaft angle

Publication History

Article published online:
15 October 2020