Locking system strengthened by biomimetic mineralized collagen putty for the treatment of osteoporotic proximal humeral fractures

Abstract

The current study is to observe the effect of the locking system strengthened by biomimetic mineralized collagen putty for the treatment of senile proximal humeral osteoporotic fractures. From January 2012 to December 2015, 80 cases of senile patients with osteoporotic proximal humeral fractures were randomly divided into an observation group and a control group, each group with a total of 40 cases. The control group was simply treated with locking plate. The observation group was treated with locking plate in combination with biomimetic mineralized collagen putty. The therapeutic effect thereby was observed. The excellent and satisfactory rate was 90% in observation group and was 72.5% in control group. The difference between the two groups was statistically significant (χ² = 5.3312, P < 0.05). The fracture healing time was 11.82 ± 3.62 weeks in observation group and 19.78 ± 5.46 weeks in control group. The shoulder joint function score was 89.63 ± 8.12 in observation group and 76.92 ± 8.18 in control group. There was significant difference between the two groups (t = 7.1272; 12.7834, P < 0.05). The complication rate was 10% in the observation group and 32.5% in the control group (χ² = 7.3786, P < 0.05). Locking system strengthened by biomimetic mineralized collagen putty has advantages such as accelerating healing of senile proximal humeral fracture, improving the therapeutic effect, reducing the complications. As one of the optimal internal fixation method, it provides a new option for better treatment of senile osteoporotic fracture.

Keywords: locking system; mineralized collagen putty; osteoporosis; proximal humeral fracture.

Figure 1.

Mineralized collagen putty was intraoperatively prepared. (a) Mineralized collagen putty blocks were taken from the package. (b) They were immersed into normal saline for about 30 seconds. (c) Liquid was extrude from the putty. (d) The putty was malaxated and kneaded by a thumb in the other palm. (e) Malaxation and knead were continued for about 2 minutes to form a paste. (f) The mineralized collagen putty paste could be squeezed through an injector

Figure 2.

In the observation group, segmental bone defects of humeral head were filled with mineralized collagen putty. (a) The fractured humeral segments were distracted to show the defect (noted by arrow). (b) The mineralized collagen putty was injected into the defect (noted by arrow)

Figure 3.

A case of 76 years old female patient diagnosed as comminuted fractures of the left proximal humerus. (a) An X-ray film taken before surgery, in which the comminuted fracture of the surgical neck of humerus could be seen. (b) Radiograph was taken one day after operation for postoperative reexamination. All fractures showed good contraposition and alignment with satisfactory internal fixation. (c) Radiograph was taken three months after operation. Fracture appeared healed with good union. There was neither osteonecrosis nor fracture of humeral head. The internal fixation nails were neither pulled out nor loosened

Figure 4.

A case of 85 years old female patient diagnosed as comminuted fractures of the right proximal humerus. (a) An X-ray film taken before surgery, in which the comminuted fracture of the surgical neck of humerus could be seen. (b) Radiograph was taken one day after operation for postoperative reexamination. All fractures showed good contraposition and alignment with satisfactory internal fixation. (c) Radiograph was taken three months after operation. The screw loosened and pierced out of the locking plate fixation. Humeral head underwent varus deformity and absorption