Operative treatment of 2-part surgical neck type fractures of the proximal humerus in the elderly: Cement augmented locking plate philos™ vs. proximal humerus nail multiloc
Injury Jun 22, 2020
Helfen T, Siebenbürger G, Fleischhacker E, et al. - A prospective randomized controlled clinical trial was designed to compare locked plating with intramedullary nailing in the treatment of displaced 2-part surgical neck type proximal humeral fractures in elderly patients. Researchers randomized patients ≥ 60 years of age with a displaced 2-part surgical neck type fracture of the proximal humerus for either augmented locking plate fixation Group LP or multiplanar intramedullary nailing Group IN. The primary endpoint included the Disabilities of the Shoulder, Arm, and Hand Score after 24 months. The age- and gender-adjusted Constant Murley Score, the American Shoulder and Elbow Score, the Oxford Shoulder Score, and the Short Form 36 after 6 weeks, 3 months, 6 months, 12, and 24 months were considered as secondary endpoints. At a 2-years follow-up, functional outcomes are similar in locked plating with screw tip augmentation compared to intramedullary nailing. In patients ≥ 60 years, both implants reached low complication- and revision rates for two-part surgical neck types fractures of the proximal humerus, whether anatomic fracture reduction, and accurate implant position was obtained.
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