EVALUATE THE ROLE OF THE CALCAR SCREWS IN OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING PLATE FOR THE TREATMENT OF THE PROXIMAL HUMERAL FRACTURES

Gia Anh Thy Le1, Ngoc Minh Dinh1,, Tan Toan Nguyen1, Minh Loc Nguyen1, Thanh Tan Pham1, Ngoc Thanh Tam Nguyen1
1 Hospital for Traumatology and Orthopaedics

Main Article Content

Abstract

Background: Fractures of the proximal humerus account for a high proportion of all fractures. The incidence and complexity of these fractures increases with patient age. Restoring the stability of the medial hinge while doing the osteosynthesis is of great interest to many surgeons. Objectives: To evaluate and compare the treatment results as well as the rate of complications: secondary displacement, humeral head necrosis of internal fixation using locking plate to treat proximal humerus fractures in two group with calcar (group N+) and without calcar screws (group N-). Materials and Methods: A retrospective clinical study described 125 patients had been done the internal fixation with locking plate at Hospital for Traumatology and Orthopaedics, Ho Chi Minh city from 2018 – 2021, of which 69 cases had calcar screws, 56 cases was without calcar screws. Assessment of functional recovery was based on the Constant-Murley scale, the secondary displacement was based on monitoring the distance form the proximal end of the plate to the tip of the humeral head, and the humeral head necrosis was based on the Cruess classification system. Results: Group N+ had a better level of functional recovery and lower level of secondary displacement than group N- with P = 0.03 and 0.01, respectively. The rate of humeral head necrosis in group N+ was 15.93% and 14.27 % in the group N- group with P = 1. Conclusion: The placement of calcar screws in the locking plate fixation of proximal humeral fractures is associated with better shoulder function recovery and maintenance of reduction.

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References

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