AAOS 2024: Locking Intramedullary Nails Vs Locking Plates for Proximal Humerus Fractures .
Locking intramedullary nails compared with locking plates for displaced three- and four-part proximal humerus fractures: a double-blinded randomized controlled trial with two-year follow-up of 76 patients
76 patients with displaced three or four-part proximal humerus fractures (PHF) were randomized to receive either a locking intramedullary nail or a locking plate. The main outcome measured was the difference in two-year Disability of the Arm, Shoulder, and Hand (DASH) scores, with secondary outcomes including Constant Score (CS), Oxford Shoulder Score (OSS), and the incidence of reoperations and complications. The results showed no statistical significance in two-year functional outcomes between the two groups. However, at six months, patients treated with nails had significantly worse CS scores and more complications than those treated with plates. There were more reoperations and incidences of avascular necrosis in the nail group.
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