Clinical study on open reduction and internal fixation with proximal humeral internal locking system (PHILOS) combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral fractures

Objective: To observe the clinical curative effect of open reduction and internal fixation with proximal humeral internal locking system( PHILOS) combined with Chinese herbal steaming and washing therapy in the treatment of complicated proximal humeral fractures. Methods: Sixty-two patients with complicated proximal humeral fractures were randomly divided into observation group and control group,31 cases in each group. Patients in the observation group were treated with open reduction and internal fixation with PHILOS combined with Chinese herbal steaming and washing therapy,while the others in the control group were merely treated with open reduction and internal fixation with PHILOS. The clinical fracture healing time were recorded and compared between the 2 groups,and the Neer shoulder performance score and grade were evaluated and compared between the 2 groups 1 year after operation. Results: There was no statistical difference in clinical fracture healing time between the 2 groups( 13. 9 +/- 4. 2 vs 14. 2 +/- 5. 6 weeks,t = 0. 138,P = 0. 887). Neer shoulder performance scores of observation group were higher than that of control group( 87. 3 +/- 4. 2 vs 82. 9 +/- 2. 9 points,t = 2. 735,P =0. 014). Twenty-five patients obtained an excellent result,3 good,1 fair and 2 poor in the observation group,while 17 patients obtained an excellent result,8 good,4 fair and 2 poor in the control group. The observation group surpassed the control group in the grade of Neer shoulder performance score( Z =- 2. 010,P = 0. 044). Conclusion: The combination therapy of open reduction and internal fixation with PHILOS combined with Chinese herbal steaming and washing has similar fracture healing time to the monotherapy of open reduction and internal fixation with PHILOS for 3-part and 4-part proximal humeral fractures. However,the combination therapy can alleviate the shoulder pain obviously and improve the shoulder function,and it is an ideal method for complicated proximal humeral fracture and worthy of popularizing in clinic.