Objective: To summarize clinical experiences of open reduction and internal fixation for the treatment of humeral surgical neck fractures.
Methods: From May 2008 to May 2013, 295 patients with humeral surgical neck fractures were divided into two groups: operation group and small splint group. In the operation group: there were 139 cases including 58 males and 81 females, treated with open reduction and locking plate fixation. The mean age of the patients was (70.3 ± 6.5) years old (ranged from 60 to 91 years old). The interval from injury to hospital ranged from 30 min to 15 days, with an average of (19.7 ± 18.4) hours. In the small splint group: there were 156 cases including 75 males and 81 females, treated with manipulative reduction and small splint external fixation. The mean age of the patients was (70.6 ± 7.0) years old (ranged from 60 to 98 years old). The interval from injury to hospital ranged from 1 hour to 15 days, with an average of (20.2 ± 20.1) hours. The therapeutic effects were evaluated with shoulder pain, function, activity, anatomical indicators and total score according to Neer Score after treatment.
Results: All the patients were followed up, and the duration ranged from 5 to 20 months, with an average of 13.2 months. According to Neer Score, the total score of patients in the operation group was 91.48 ± 7.46; while in the small splint group, the score was 85.62 ± 7.61; the score of patients in the operation group was higher than that of small splint group.
Conclusion: Compared with small splint external fixation, the method of open reduction and internal fixation for the treatment of humeral surgical neck fracture in aged patients has several advantages such as reducing pain, improving functional recovery, getting a better anatomical position and better clinical effects.