Locking Intramedullary Nails Versus Locking Plates in the Treatment of 2-part and 3-part Proximal Humeral Surgical Neck Fractures in Elderly Patients: A Prospective Cohort Study

Abstract Background: Locking intramedullary nails and locking plates are most widely used in the treatment of 2-part and 3-part proximal humeral surgical neck fractures, however, the clinical outcomes are controversial. This study aimed to compare the clinical outcomes of treatment with these two implants in elderly patients.Methods: In this prospective cohort study with a 24-month follow-up period, from June 2014 to November 2016, a total of 53 elderly patients with 2-part and 3-part proximal humeral surgical neck fractures treated with locking intramedullary nails and locking plates were included. We analyzed the intraoperative and radiographic parameters. The American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score and range of motion (ROM) were used to evaluate shoulder function. We also assessed the visual analog scale (VAS) score and complication rate.Results: For both 2-part and 3-part proximal humeral surgical neck fractures, the nail group showed statistically significant superiority compared with the plate group in terms of the operative duration, incision length, blood loss, hemoglobin loss, neck-shaft angle (NSA) loss, time to bony union and pain. Good to satisfactory clinical outcomes were obtained with both types of implants. Significant differences were not found in the functional results or complication rate between the two groups at different time points during the follow-up period.Conclusions: Treatment with both locking intramedullary nails and locking plates achieves similar and good to satisfactory clinical outcomes in elderly patients. We favor locking intramedullary nails, especially in the treatment of 2-part proximal humeral surgical neck fractures.Trial registration: Medical Ethics Committee for Clinical Research of Zhongda hospital, ZDYJLY (2014) new No. 9. Registered 05 March 2014，http://www.njzdyy.com

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Locking Intramedullary Nails Versus Locking Plates in the Treatment of 2-part and 3-part Proximal Humeral Surgical Neck Fractures in Elderly Patients: A Prospective Cohort Study

10.21203/rs.3.rs-29763/v2 ◽

2020 ◽

Author(s):

Rui Geng ◽

Hao Wu ◽

Ke Ren ◽

Qing Chang ◽

Yalikun Yusufu ◽

...

Keyword(s):

Cohort Study ◽

Elderly Patients ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Locking Plates ◽

Intramedullary Nails

Abstract The authors have withdrawn this preprint due to erroneous posting.

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Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study

QJM ◽

10.1093/qjmed/hcaa178 ◽

2020 ◽

Vol 113 (9) ◽

pp. 657-665 ◽

Cited By ~ 14

Author(s):

X Wang ◽

H Xu ◽

H Jiang ◽

L Wang ◽

C Lu ◽

...

Keyword(s):

Cohort Study ◽

Clinical Outcomes ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Close Contact ◽

Post Discharge ◽

Global Pandemic ◽

Discharged Patients ◽

Suspected Recurrence

Summary Background Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described. Aim To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge. Design A prospective cohort study. Methods Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks. Results Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks post-discharge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study. Conclusion The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.

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