Hematologic evaluation and short-term clinical effect of reverse needle fixation in high-risk elderly patients with proximal humeral fractures
YANG Mingshuai1 TIAN Yafeng1 ZHANG Yili2 XUE Pengyu2 CHEN Baosheng2 FAN Jinrui2 YANG Yipeng2 ZHOU Hai2
1.The First Department of Orthopedics, Hebei Hospital of Traditional Chinese Medicine the First Affiliated Hospital of Hebei University of Chinese Medicine, Hebei Province, Shijiazhuang 050000, China;
2.Graduate School, Hebei University of Chinese Medicine, Hebei Province, Shijiazhuang 050011, China
Abstract：Objective To investigate the hematologic evaluation and short-term clinical effect of reverse needle fixation in high-risk elderly patients with proximal humeral fractures. Methods The retrospective analysis was performed on 28 high-risk elderly patients with proximal humerus fracture treated by reverse needle puncture external fixation in the First Department of Orthopedics, Hebei Hospital of Traditional Chinese Medicine from January 2018 to January 2022. Data on operative time, intraoperative blood loss, length of stay, removal time of external fixator, and complications were collected. The levels of red blood cell count, hemoglobin, and hematocrit were compared before surgery and seven days, three months, six months after surgery. Constant-Murley score and shoulder surgery system score were used to evaluate the clinical efficacy. Shoulder joint X-ray image was used to observe the degree of fracture healing. Results The mean operation time of the 28 patients was (66.57±18.09) min, the mean intraoperative blood loss was (12.02±2.52) ml, the mean hospital stay was (14.39±2.86) d, and the mean removal time of external fixation was (6.75±1.70) months. No obvious complications occurred. There was no significant difference in the red blood cell count, hemoglobin, and hematocrit before surgery and at seven days, three months, six months after surgery (P＞0.05). The total Constant-Murley score and scores of pain, daily activities, range of motion of shoulder joint, and muscle strength were increased gradually before surgery and at seven days, three months, six months after surgery, the differences were statistically significant (P＜0.05). The scores of the shoulder surgery scoring system of patients before surgery and at seven days, three months, six months after surgery were gradually decreased, and the differences were statistically significant (P＜0.05). X-ray images of the shoulder joint showed good healing. Conclusion The hematologic evaluation of the treatment of high-risk elderly patients with proximal humerus fracture by reverse needle fixation is stable, and the short-term clinical effect after surgery is satisfactory, which is suitable for high-risk elderly patients.
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