CHOICE OF THE OPTIMAL METHOD OF SURGICAL TREATMENT OF COMPLEX FRACTURES AND FRACTURE-DISLOCATIONS OF THE PROXIMAL HUMERUS

Purpose and objectives of the study:evaluate and compare the results of surgical treatment of complex fractures and fractures of the proximal humerus. Materials and methods: an analysis of the results of surgical treatment of 202 patients with 3 and 4 fragmentary fractures and fractures of the proximal humerus was performed. During the period of 2015-2017 in the City Clinical Hospital named after V.P. Demikhov. Results: Based on the analysis of surgical treatment of 202 patients with fractures and complex fractures of proximal metaepiphysis of the humerus within 7 days from the time of injury, we came to the conclusion that the most effective method is endoprosthesis of the shoulder joint by a reversible system. This method allows you to reach the maximum amplitude of movements in the shoulder joint in the early stages of rehabilitation treatment. In the main group, where reversive endoprosthetics were used, excellent and good results on the Constant-Murley and ASES scales were obtained in 46 patients (85.2%). Unsatisfactory outcomes were not encountered. More modest results were obtained in the groups where the osteosynthesis of the fractures with pins and plates was performed, and hemiarthroplasty for the surgical treatment of "fresh" fractures and complex fractures of the proximal metaepiphysis of the humerus was found to be untenable.