Objective To explore the advantages of the technique of medial humeral screws and rotator cuff suture in the treatment of proximal humeral fracture and its influence on the functional recovery of shoulder joint.
Methods Total 33 patients with proximal humeral fractures treated by surgery from June 2017 to March 2019 were retrospectly analyzed. All patients were treated surgically through the deltoid approach of pectoralis major muscle. The proximal humerus anatomical locking plate for internal fixation was used, and the medial support of calcar screw and the rotator cuff suture technique were implanted into the plate foramen. All patients were followed up. The fracture type, age, hospital day, operation time, incision length, operative bleeding volume, incidence of complications were analyzed.
Results Thirty-three cases of proximal humeral fractures were treated with medial support of calcar screw combined with rotator cuff suture technique: 16 cases of Neer type Ⅱ, 13 cases of Neer type Ⅲ and 4 cases of Neer type Ⅳ. The average age of the patients was(59.8±12.3) years, the average operation time was(102.6±29.2) minutes, the average intraoperative bleeding volume was(167.6±121.5) mL, the average incision length was(12.5±2.6) cm, the average length of hospital day was(13.3±6.3) days, the incidence of complications was 6.1%, and the excellent rate of Constant-Murley shoulder function score was 87.9%.
Conclusion Clinical effect of medial support combine with rotator cuff suture for treating proximal humeral fracture is effective. Advantages: ① It can effectively reduce and stabilize the fracture of large and small tubercles; ② It repairs the injured rotator cuff, reduces the varus stress of rotator cuff on the humeral head, thereby reducing the risk of screw cutting out; ③ The humeral calcar screw is located in the high bone density area, with good screw holding force and stability, which can reduce the chances of humeral head varus and screw cutting out; ④ Shoulder joint function exercise can be performed early after operation and the recovery of shoulder joint function is satisfactory.
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