[Comparative study of combined external fixator and plate fixation in the treatment of humerus throwing fracture]

To compare clinical efficacy of combined external fixator and plate fixation in treating throwing fracture of humerus.

Sixty-seven male patients with throwing humerus fracture admitted from February 2018 to February 2021 were retrospectively analyzed and divided into external fixator group and plate group according to different treatment methods. There were 32 patients in external fixator group, aged from 18 to 27 years old with an average of (23.6±2.6) years old;19 patients with type A, 13 patients with type B according to AO classification;fixed by combined external fixer. There were 35 patients in plate group, aged from 17 to 28 years old with an average of (23.2±2.9) years old;21 patients with type A, 14 patients with type B according to AO classification;fixed with steel plate screws. Operation time, intraoperative blood loss, total incision length, fracture healing time and complications were compared between two groups. Clinical effect was evaluated by Mayo elbow performance score (MEPS) and shoulder Neer score at 12 months after operation.

Patients in both groups were successfully completed operation and followed up for 15 to 21 months with an average of (18.3±3.4) months. In external fixator group, intraoperative blood loss, incision length, fracture healing time and postoperative MEPS of elbow joint function at 12 months were (68.5±15.7) ml, (4.9±1.2) cm, (10.5±2.9) weeks, (93.6±5.1) min, respectively;which were superior to ml (149.4±38.9) ml, (12.5±2.4) cm, (12.8±2.7) weeks, (85.6±6.8) in plate group (P<0.05), and had significant differences;there were no significant difference in operative time and postoperative Neer score of shoulder joint function at 12 months between two groups (P>0.05). There were 6 patients occurred radial nerve injury in plate group and no patient occurred radial nerve injury in external fixator group, and the difference between two groups was statistically significant (χ²=6.025, P<0.05). There were no significant difference in postoperative MEPS grading and Neer shoulder joint grading at 12 months (P>0.05). Bone healing was achieved in both groups without failure of internal fixation.

The combined external fixator for the treatment of humerus throwing fracture has characteristics of low incidence of radial nerve injury, less bleeding, less complications, fast fracture healing, which is convenient to remove after fracture healing.