J Korean Fract Soc.  2011 Apr;24(2):144-150. 10.12671/jkfs.2011.24.2.144.

Comparison of Results between Internal Plate Fixation and Hemiarthroplasty in Comminuted Proximal Humerus Fracture

• Kim DS
• Lee DK
• Yi CH
• Park JH
• Rah JH

• KMID: 2183856
• DOI: http://doi.org/10.12671/jkfs.2011.24.2.144

Abstract

PURPOSE
Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures.
MATERIALS AND METHODS
Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically.
RESULTS
On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75+/-6.5 points and 70+/-7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78+/-5.4 points from the former and 71+/-2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72+/-8 points for the internal fixation group and 69+/-9.2 points for the hemiarthroplasty group (p=0.041).
CONCLUSION
Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.

Keyword

Comminuted proximal humerus fracture; Internal fixation; Hemiarthroplasty

MeSH Terms

Follow-Up Studies
Hemiarthroplasty
Humans
Humeral Head
Humerus

Figure

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  Fig. 1 (A) The initial simple radiograph taken in the emergency room of a 54-years old female show comminuted proximal humerus fracture. (B) Internal fixation was done with a plate and screws 1 day after the injury. (C) Follow up radiograph was taken 24 weeks after surgery, bony union was achieved.

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  Fig. 2 (A) The initial simple radiograph taken in the emergency room of a 68-years old male show comminuted proximal humerus fracture (4-part). (B) Hemiarthroplasty was performed 4 days after surgery. (C) Follow up radiograph was taken 18 weeks after surgery. The radiograph shows stable fixation of implant.

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