AAOS2019: Similar PROMs, lower reoperation rate with nail vs. plate for 3-/4-part humerus fractures .
Displaced 3- and 4-Part Proximal Humeral Fractures: A Prospective Randomized Study Comparing Intramedullary Nail and Locking Plate
75 patients with a 3- or 4-part humerus fracture were randomized to fixation with either a locking intramedullary nail or locking compression plate. Patients were assessed over a minimum of 24 months after surgery for clinical scores, radiographic outcome, and incidence of complications and reoperation. Clinical scores, including visual analog pain scores, the Constant Score, and the American Shoulder and Elbow Surgeons (ASES) score, demonstrated no significant differences between the two groups. Rates of malunion/nonunion and avascular necrosis development were also similar between groups. A lower rate of hardware removal due to humeral impingement was observed among patients treated with the nail in comparison to patients treated with the plate.
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