Comparison of surgical efficacy of locking plates and interlocking intramedullary nails in the treatment of proximal humerus fractures

Abstract

Background The objective of this study was to evaluate the efficacy of locking plates versus interlocking intramedullary nails in the treatment of proximal humerus fractures to provide clinical data support and theoretical guidance. Methods Patients with proximal humerus fracture from the Third hospital of Shijiazhuang city and Third hospital of Hebei medical university and from January 2017 to June 2019 were selected, included and divided into the locking plate group and the interlocking intramedullary nail group according to the intervention received. Information pertaining to the perioperative period (operation time, hospital stay, blood loss, etc.) of patients in both groups was collected. VAS pain scores, shoulder activity Constant-Murley scores and postoperative complications were documented. The perioperative data of the two groups were compared, and P < 0.05 was considered statistically significant. Results A total of 64 patients were enrolled, including 36 patients in the locking plate group, with a mean age of 61.3 ± 13.9 years, while the mean age of the interlocking intramedullary nail group was 65.6 ± 11.2 years. There was no statistical difference in gender, affected side, injury mechanism and Neer classification between the two groups (P > 0.05). However, the average operation time of the locking plate group was shorter than that of the interlocking nail group (84.9 ± 11.7 vs. 102.6 ± 22.1 min, P = 0.00), and the intraoperative blood loss of the locking plate group (137.4 ± 16.8 ml) was higher than that of the interlocking nail group (72.5 ± 10.5 ml, P = 0.00). There was no significant difference in the VAS score and Constant-Murley score between these two groups at the final follow-up. Conclusion Interlocking intramedullary nails are more minimally invasive than locking plates, but fracture reduction and fixation take longer. There was no significant difference in pain and shoulder function scores between the two internal fixation strategies for the treatment of proximal humerus fracture.

Proximal Humerus Fracture Treated with Locking Plate Fixation and Fibula Autograft: Case Report

“…On the contrary, proximal humerus locking intramedullary nails have become increasingly popular with orthopedic physicians because of their minimally invasive insertion and good stability. Currently, there are no studies comparing the efficacy and safety of locking plates and intramedullary nail fixations in the treatment of OTA/ AO type 11C1.1 and 11C3.1 proximal humerus fractures [2,[17][18][19].…”

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

“…There are benefits and limitations of ILN or LCP use (20)(21)(22). Although the LCP counteracted bending and torsion to a similar degree as the ILN-10, some intricacies of LCP placement require consideration and might make them less suitable implants for a particular situation.…”

Outcome and complication comparison for intramedullary nail versus open reduction internal fixation in humeral diaphyseal fractures for 2800 matched patient pairs utilizing the Nationwide Readmissions Database

“…While current literature provides conflicting information on which procedure requires the longest amount of time, there is less blood loss associated with IMN than ORIF. IMN requires a smaller incision than what is required for plating, with less associated blood loss [ 18 , 19 ]. These data add to the growing body of literature comparing the two surgical methods in an attempt to optimize outcomes for humeral diaphyseal fractures.…”