A comparative study of locking plate combined with minimally invasive plate osteosynthesis and intramedullary nail fixation in the treatment of Neer classification of 2-part and 3-part fractures of the proximal humerus

Abstract

Abstract Objective:To compare the clinical efficacy of minimally invasive locking plate technique (Philos plate) and interlocking intramedullary nailing technique (TRIGEN intramedullary nail) in the treatment of Neer two-part and three-part proximal humeral fractures. Methods and materials:The clinical data of 60 patients with Neer two-part and three-part proximal humerus fractures admitted to Hospital from April 2017 to April 2020 were retrospectively analyzed. 32 cases were treated with minimally invasive locking plate technique (minimally invasive plate group) and 28 cases were treated with interlocking intramedullary nailing technique (intramedullary nail group). The operation time, intraoperative blood loss, incision length, fracture healing time, and postoperative complications were compared between the two groups. ASES score and Constant-Murley score were used to evaluate the shoulder joint function of the two groups one year after surgery. Results:All 60 patients were followed up for 12 to 24 months, with an average of 16 months. There was no significant difference in operation time, intraoperative blood loss, incision length and fracture healing time between the two groups (P>0.05). The incidence of postoperative complications in the intramedullary nail group was significantly lower than that in the minimally invasive steel plate group, and the difference between the groups was statistically significant (P<0.05). There was no significant difference in ASES score and Constant-Murley score between the two groups one year after surgery (P>0.05). Conclusion:The use of minimally invasive locking plate technique and interlocking intramedullary nailing technique in the treatment of Neer two-part and three-part proximal humerus fractures has the advantages of small incision, less blood loss, and high fracture healing rate, and both can achieve satisfactory clinical effects. The internal nail technique is more convenient than the minimally invasive locking plate technique in controlling postoperative complications.