РЕЗУЛЬТАТЫ ОСТЕОСИНТЕЗА ПЕРЕЛОМОВ ПРОКСИМАЛЬНОГО ОТДЕЛА ПЛЕЧЕВОЙ КОСТИ ИНТРАМЕДУЛЛЯРНЫМ ШТИФТОМ С ДОПОЛНИТЕЛЬНОЙ МЯГКОТКАНОЙ СТАБИЛИЗАЦИЕЙ БУГОРКОВ

Surgical treatment of proximal humeral fractures has always been a challenge for the trauma surgeon. Intramedullary locked nailing is becoming a popular alternative treatment. But the high rate of postoperative complications and unsatisfactory outcomes remain a matter of dispute. Objective – to evaluate outcomes of surgical treatment of patients with proximal humerus fractures with use of intramedullary locked fixation, using the standard technique with closed reposition and with the offered technique of semi-opened reposition and additional suture fixation of tuberosities. Materials and methods. From 2009 to 2014, 35 patients (26 females, 9 males) underwent the intramedullary fixation using closed reduction and nails of the first and second generation. Basing on treatment results of this group, the modified fixation technique was created and used since 2014. The comparison group consisted of 35 patients (27 females, 8 males) who underwent mini-open reduction, and intramedullary nailing with the second generation nails only and additional suture fixation of tuberosities. Results. Evaluation with Constant Shoulder Score made up 73.6 ± 14.8 points in the first group against 93.1 ± 7.0 in the second one, with Quick Dash Score – 24 ± 17 points in the first group against 4.7 ± 5.0 in the second one. Conclusion. The obtained data showed the high efficacy of intramedullary nailing combined with mini-open reduction and additional suture fixation of tuberosities in all types of proximal humeral fractures.