Abstract：【Objective】 To investigate the effect of different numbers of medial column supporting screws on proximal humeral fracture with locking plate. 【Methods】 A retrospective analysis of the clinical data of 76 patients with proximal humeral fractures treated in the Orthopedics Department of our hospital from August 2017 to September 2018. They were divided into 4 groups based on the number of medial column support screws used in the surgery: There were 25 patients in the non-supporting screw group, 19 patients in the 1 supporting screw group, 17 patients in the 2 supporting screws group, and 15 patients in the 3 supporting screws group. During the follow-up of 12 months, the shear stiffness, compressive stiffness, fracture healing time, humeral head height loss value, neck shaft angle, varus angle, constant shoulder score and postoperative complications were compared between the four groups. 【Results】 The patients with three supporting screws had the highest shear stiffness and compressive stiffness, which were better than those without supporting screws, one supporting screw group and two supporting screw group (P<0.05). The fracture healing time without supporting screw, 1 supporting screw group, 2 supporting screws group, and 3 supporting screws group were (14.25 ± 2.30), (14.33 ± 2.45), (15.18 ± 3.51)and (15.68 ± 4.63),respectively. There were no statistically significant differences in fracture healing time and neck-shaft angle between the four groups (all P>0.05). The values of humeral head loss and varus angle in group A, group B, group C, and group D decreased sequentially, and the difference between the groups was statistically significant (P<0.05). The Constant scores of shoulder joint function increased gradually in groups A, B, C, and D at 1 month, 2 months, 3 months, 6 months, and 12 months after surgery. The Constant score of group D was the highest, and there were differences between the groups (P<0.05). The incidence of postoperative complications in the 3 supporting screws group, 2 supporting screws group, 1 supporting screw group, and no supporting screw group were 40%(10/25)、42.10% (8/19)、17.64% (3/17) and 13.34% (2/15), respectively. The differences of groups were not statistically significant (P> 0.05). 【Conclusion】 Choosing 2 or 3 screws to support the medial column can achieve a satisfactory recovery results the treatment of proximal humeral fractures with locking plate. The use of 3 supporting screws has the best clinical effect.
贺世集, 党亚军. 内侧柱不同支撑螺钉数量对锁定钢板治疗肱骨近端骨折疗效的影响[J]. 医学临床研究, 2021, 38(4): 539-542.
HE Shi-ji, DANG Ya-jun. Effect of Various Medial Column Supporting Screws on in the Treatment of Proximal Humeral Fracture with Locking Plate. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 539-542.
2021, Vol. 38 
