[Treatment of proximal humerus fractures combined with shoulder dislocation using bone setting manipulation].

OBJECTIVE: To explore the treatment skill and clinical effect of bone setting manipulation in treating proximal humeral fracture with shoulder dislocation.

METHODS: From January 2015 to December 2015, 118 cases of proximal humeral fractures with shoulder joint dislocation were treated by bone setting reduction and fixation with adhesive tape or Kirschner wire after reduction, including 56 males and 62 females with an average age of 61 years old ranging from 48 to 88 years old. The time from injury to treatment was 1 to 31 days with an average of 3 days. All fractures were closed, according to Neer standard classification, there were 27 cases of type II, 55 cases of type III and 36 cases of type IV. There were 85 cases of shoulder subglenoid dislocation, 33 cases of subcoracoid dislocation. All the patients were accompanied by obvious shoulder joint deformity, dysfunction and other symptoms. All cases were diagnosed by X-ray examination, and the bone setting manipulation was performed under the brachial plexus anesthesia. According to the type of fracture and fixation method, the patients were encouraged to exercise the limb rehabilitation, and the curative effect was determined by Constant-Murley shoulder score system.

RESULTS: All cases were followed up for 6 to 12 months with an average of 9 months. There were 1 case of humeral head necrosis, 2 cases of traumatic frozen shoulder. The score of shoulder joint function Constant-Murley was 84.5±4.5; among them, 78 cases were excellent, 28 cases were good, 9 cases were fair, 3 cases were poor, the excellent and the good rate was 89.8%. X-ray showed bony union of all cases.

CONCLUSIONS: The treatment of proximal humeral fracture with dislocation of shoulder joint by bone setting manipulation is a skillful method, with simple operation, small trauma and satisfactory curative effect.