Objective:To compare biomechanical characteristics of crossing Kirschner wire,anatomical steel plate,ender nail combined with tension band and locking proximal humerus plate(LPHP)for the treatment of proximal humeral three-part fracture,and discuss surgical skill of different internal fixations.Methods:32 humeral specimens were created three-part proximal humeral fractures in term of Neer criterion,and randomly divided into 8 groups averagely.Groups of A1 and A2 were fixed with crossing Kirschner wire and screw;Groups of B1and B2 with anatomical steel plate;Groups of C1and C2 with ender nail combined with tension band;Groups of D1and D2 with LPHP.The specimens of group A1,B1,C1 and D1 were performed the compression test,while the specimens of A2,B2,C2 and D2 the tension test.Results:The maximum compression loading of B1,C1 and D1 groups were higher than that of A1 group(P<0.05).The stiffness of B1 and D1 was higher than that of C1 and A1(P<0.05).The maximum tension loading of C2 and D2 groups were higher than that of A2 and B2(P<0.05).The stiffness of C2 and D2 was higher than that of A2 and B2(P<0.05).Conclusions:LPHP works well at excellent stabilization.It's stabilization and clinical efficacy are better than that of other internal fixations.

Objective To discuss the surgical treatment of complex proximal humeral fractures.Methods From January 2002 to January 2007,70 patients with three-part proximal humeral fracture were divided into 4 groups.There were 20 patients in the group A who underwent internal fixation with crossing Kirschner wires combined with screws,23 in the group B underwent open reduction and internal fixation with anatomical steel plates,15 in the group C were treated by ender nails combined with tension bands,open reduction and internal fixation with locking proximal humerus plates were performed for the 12 patients in the group D.Results The seventy cases were followed up for an average of 11.5 months(10~19 months).The function of the shoulder joint was evaluated with Neer scoring.In group A,3 were excellent,11 were good and 6 were fair,the excellent and good rates were 70.0%,in group B,5 were excellent,12 were good,3 were fair,the excellent and good rates were 73.9%.In group C,7 were excellent,5 were good,2 were fair and 1 was poor,the excellent and good rates were 80.0%.In group D,5 were excellent,5 were good,1 was fair and 1 was poor,the excellent and good rates were 83.3%.The clinical efficacy of group C and D was much better than that of A and B(P0.05).There was no significant difference between group C and D(P0.05)or between A and B.Conclusions LPHP will perform better stabilization and clinical efficacy than that of other internal Fixations.The ender nail combined with tension band also can provide good stabilization and clinical efficacy.