Analysis of clinical efficacy of Wu-Men manipulative therapy in treating proximal humeral comminuted fractures in the elderly
GONG Guan-yi,YOU Pei-jie,LIU Jin-tao
Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215000，China
Abstract:
Objective To analyze and compare the clinical efficacy of Wu-Men manipulative therapy versus open reduction and internal fixation (ORIF) with plate osteosynthesis for treating proximal humeral comminuted fractures in elderly patients. Methods Fifty-three elderly patients with proximal humeral comminuted fractures treated at Suzhou Hospital of Traditional Chinese Medicine were enrolled. Twenty-six patients received Wu-Men manipulative therapy (observation group), and the remaining twenty-seven underwent ORIF with plate osteosynthesis (control group). Visual analog scale (VAS) scores for pain, Constant-Murley shoulder scores, and the relative height of the humeral head were compared between the two groups after treatment (post-reduction, and at 1 month, 3 months, and 9 months). Associated complications were observed and documented. Results A total of fifty-three patients were enrolled (26 in the observation group and 27 in the control group). All 53 patients achieved clinical fracture healing. Post-treatment, significant improvements in VAS scores, Constant-Murley scores, and humeral head relative height were observed in both groups. At the final follow-up, no statistically significant differences between groups were found in these measures (P >0.05). In the observation group, 13 patients had malunion. In the control group, one patient experienced postoperative wound nonunion, and two patients developed shoulder impingement syndrome. Conclusion Wu-Men manipulative therapy provides satisfactory clinical outcomes in elderly patients with proximal humeral comminuted fractures. It has advantages such as minimal invasiveness, low risk, early functional exercise, and cost-effectiveness. However, it is associated with a higher rate of malunion and inadequate early-stage pain management.
