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

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.

Effectiveness and Safety of Interventions for Treating Adults with Displaced Proximal Humeral Fracture: A Network Meta-Analysis and Systematic Review

“…Four trials [23, 34–36, 47] mentioned incomplete outcome data reporting (Fig 2). As assessed by the Newcastle—Ottawa Scale, six case—control studies [21, 22, 27, 30, 38, 39] were awarded a score of nine points, eleven studies [15, 16, 20, 25, 28, 29, 31, 41, 42, 45, 46] received a score of eight points, six studies [18, 23, 26, 33, 43, 44] received a score of seven points, and only one study [32] received a score of six points (Table 2). …”

“…The following interventions for treating displaced proximal humeral fracture were tested in the trials: ORIF versus HA (10 trials with 533 patients) [15, 19, 23, 28, 32, 38, 39, 43, 44, 46]; HA versus RSA (3 trials with 147 patients) [16, 25, 36]; HA versus NOT (2 trials with 96 patients) [17, 34]; ORIF versus IN (5 trials with 491 patients) [27, 30, 33, 37, 47]; ORIF versus NOT (4 trials with 152 patients) [24, 29, 35, 48]. …”