Locking nail versus locking plate for proximal humeral fracture fixation in an elderly population: a prospective randomised controlled trial

68 patients with a proximal humerus fracture were randomized to fixation with either an intramedullary nail (Locking Blade Nail; Marquard) or a locking plate (Proximal Humerus Interlocking Osteosynthesis [PHILOS] system; DePuy Synthes). Patients were assessed for outcome related to function and complications over 1-year follow-up. Results for the primary outcome measure of the Constant score, as well as secondary outcomes for pain and range of motion demonstrated no significant differences between groups at 3 months, 6 months or 1 year. The Disabilities of the Arm, Shoulder, and Hand score demonstrated a significant between-group difference in favour of the nail group at 1 year, but not at 3 or 6 months. Overall rate of complications did not significantly differ between groups, though incidence of screw cut-out, specifically, was significantly lower in the nail group compared to the plate group.