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In the short term, results with TT cups appear to be encouraging, with satisfactory survival rates for both simple and complex cases.

There were 21 fractures of the proximal part of the humerus and 7 fractures that also involved the shaft; 15 of the fractures were two-part fractures (surgical neck), 5 were three-part fractures, and 1 was a four-part fracture. All fractures healed in a mean period of 2.7 months. There was one delayed union that healed in 4 months. One case of avascular necrosis of the humeral head was observed (a four-part fracture), but remained asymptomatic and did not require further treatment. In one case a back-out of one proximal screw was observed. A final evaluation with a minimum 1 year follow-up was performed by an independent observer; in 18 patients, the mean Constant score was 65.7 or 76.1% with the adjustment of age and gender; in 19 patients, the mean Oxford Shoulder Score was 21.7. The results obtained with the T2-PHN nail indicate that it represents a safe and reliable method in the treatment of two- and three-part fractures of the proximal humerus. The proximal fixation mechanism diminishes the rate of back-out of the screws, a frequent complication described in the literature. Better functional results were obtained from the patients younger than 70 years, but these were not statistically significant.

The aim of this study is to compare the functional and radiological results of Philos plate and NHP-T2 nail for the treatment of displaced 2-part proximal humeral fractures. Between May 2005 and June 2006, we operated 29 2-part humeral fractures. The selection of the implant was not randomized, but it was surgeon choice. There were 15 patients operated with the NHP-T2 nail (group A) and 14 patients with the Philos plate (group B). There were no statistical diVerences between the preoperative data of the two groups: mean age, sex distribution, level of activity, mechanism of injury, type of fracture, associated fractures, or the hematocrit levels. The patients were assed clinically and radiologically months after surgery. At 1-year followup, an independent evaluator additionally determined the Constant and Oxford scores. All fractures except one healed in the Wrst 3 months. In group A, there was one delayed union that healed at 4 months. There were 2 malunion cases in each group. No case of avascular necrosis of the humeral head was observed. There were no statistical diVerences between the functional results of the implants. We had more patients who required blood transfusion in group B and more fractures of the entry point and implant removal in the group A. The consolidation rate and functional results are similar in both groups, with no statistical signiWcance. The complications appeared seemed to be approach related and did not inXuence the Wnal results. An accurate technique and suYcient experience are needed to achieve a correct reduction and Wxation.

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