The use of adjuvant anteromedial support plate fixation in the treatment of comminuted proximal humerus fractures: A retrospective observational study.

Proximal humerus fractures (PHFs) are clinically common and are usually treated with proximal lateral locking compression plate fixation. However, for partial comminuted PHFs, lateral plate fixation cannot restore the support of the proximal humerus medial column, so there are more postoperative complications and even surgical failure. To improve the success rate of proximal humeral comminuted fracture surgery and reduce the complications, we used anteromedial support plate combined with lateral locking compression plate for the treatment of proximal humeral comminuted fracture. From January 2017 to April 2023, 31 cases of comminuted PHFs were treated, of which 17 cases were treated with lateral locking compression plate of proximal humerus, and 14 cases were treated with anteromedial support plate combined with lateral locking compression plate of proximal humerus. The operative time, intraoperative bleeding loss, postoperative visual analogue scale score, postoperative Constant-Murley score, fracture healing time, operative complications, and internal fixation were compared between the 2 groups. There were no statistical difference in preoperative general data between the 2 groups. All cases were followed up from 6 to 24 months, with an average of 14.50 months. There was significant difference in fracture healing time between the 2 groups. No significant differences: operation time, intraoperative beding loss, visual analogue scale score 3 months after surgery, and Constant-Murley score 8 months after surgery. Complications: 2 cases in the double plate group; 5 cases in the single plate group. The excellent and good rate was 78.57% (11/14) in double plate group and 76.47% (13/17) in single plate group. In the comminuted PHF, the anteromedial support plate can reconstruct the support function of the internal humerus column, improve fracture stability, reduce complications, and facilitate the functional recovery of the shoulder joint. The postoperative effect is satisfactory. However, the number of clinical cases in the group is small, the follow-up time is short, further study is needed, and the study is a retrospective single-center study, which may have selection bias.