To investigate the therapeutic effect of medial column bone graft combined with PHILOS plate internal fixation for the treatment of proximal humeral adductal fractures in the elderly.

The clinical data of 26 elderly patients with proximal humeral adductal fractures treated by the Department of Traumatology, Zhoushan Guhechuan Hospital from August 2013 to December 2016 were retrospectively analyzed. There were 11 males and 15 females, aged 61-89 years, with an average age of 75±14 years. All patients were admitted to the hospital from trauma to shoulder pain. And CR showed a proximal humerus fracture. 14 cases were treated with medial column bone graft combined with PHILOS plate internal fixation. The cases were not bone grafted, and the PHILOS plate internal fixation was used alone. The postoperative regular outpatient review and X-ray films were performed. The shoulder-joint function Constant-Murley score, operation time, bone healing time and neck dry angle loss angle during bone healing were observed. And other related indicators were used to comprehensively judge the treatment effect.

Bone healing was observed in all patients at the last follow-up. The excellent and good rate of Constant-Murley score of shoulder joint function in bone graft group was higher than that in non-bone graft group [13 (92.86%) vs 9 (75%), P<0.05], the time of bone healing in bone graft group was shorter than that in non-bone graft group [(10.05<3.04) vs (13.03<2.85), P<0.05], and the angle of neck and shaft angle loss in bone graft group was lower than that in non-bone graft group [(5.12<4.51) vs (11.63 + 7.04), P<0.05], the difference was statistically significant (P<0.05). There was no significant difference in operation time between the two groups (P>0.05).

Compared with non-bone grafting, medial column bone graft combined with PHILOS plate for the treatment of senile proximal humeral adductal fracture can achieve more satisfactory clinical results.