Objective To investigate the affect of reconstructing medial-column’s stability on the outcome of displaced proximal humeral fracture treated with locking plate in elders. Methods A retrospective analysis was conducted on 28 elder patients with displaced proximal humeral fracture with locking plate from November 2012 to January 2016. These cases were divided by the stability of medial-column into stable group(15 cases) and unstable group(13 cases).Results The follow-up duration varied from 7 to 44 months (mean 25.3 months). There was no statistical significant difference between the two groups in age, gender, Neer classification and fracture healing time. The height loss of humerus head was (1.6±0.7)mm and varus angle was (1.8±2.0)° in stable group, which was significant lower than the counterparts in unstable group which was (3.8±1.4)mm and (5.8±3.6)°,(P<0.05). The Constant shoulder score in stable group was (76.7±6.2)points and the excellent and good rate was 92.9%, which was significant higher than the data of unstable group which was (70.0 ±5.8)points and 69.2%,(P<0.05). Conclusion The reconstruction of the stability of medial column can effectively improve the curative out-come when treating displaced proximal humeral fracture with locking plate in elders.%目的：探讨重建内侧柱稳定性对于锁定接骨板治疗老年肱骨近端粉碎性骨折术后疗效的影响。方法回顾性研究2012年11月＿2016年1月以锁定接骨板治疗老年肱骨近端粉碎性骨折的病例共28例,根据术后X片所见骨折内侧柱的稳定性分为稳定组15例,不稳定组13例。结果随访7~44个月(平均25.3个月),两组的年龄、性别、Neer分型、骨折愈合时间差异无统计学意义,稳定组肱骨头高度丢失(1.6±0.7)mm,内翻角(1.8±2.0)°,Constant评分(76.7±6.2)分,优良率92.9%；不稳定组肱骨头高度丢失(3.8±1.4)mm,内翻角(5.8±3.6)°,Constant评分(70.0±5.8)分,优良率69.2%。稳定组的术后肱骨头高度丢失、内翻角均比不稳定组低(P<0.05),Constant评分及优良率比不稳定组高(P<0.05)。结论重建内侧柱稳定性可有效提高锁定接骨板治疗老年肱骨近端粉碎性骨折的术后疗效。
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