A comparison study of phlios plate and multiloc nail in treatment of proximal humerus fractures

Abstract

Objective To evaluate the clinical and radiological results of Phlios plate and Multiloc nail in treatment of proximal humerus fractures. Methods From February 2013 to December 2015, data of 37 cases of proximal humerus fractures who were treated by reduction and fixation using Phlios plate or Multiloc nail were retrospectively analyzed. In group one (Phlios plate), there were 10 males and 8 females, with an average age of 56.3±5.8 years, including 7 cases of Neer 2-part surgical neck fracture, 6 cases of Neer 3-part fracture, 4 cases of Neer 4-part fracture, and 1 case of fracture-dislocation. In group two (Multiloc nail), there were 8 males and 11 females, with an average age of 57.2±7.4 years, including 8 cases of Neer 2-part surgical neck fracture, 9 cases of Neer 3-part fracture, 1 case of Neer 4-part fracture, and 1 case of fracture-dislocation. Operation time, range of motion of shoulder joint, visual analogue scale (VAS) pain score, American Shoulder & Elbow Surgeon (ASES) score and Constant-Murley score were collected. Results All 37 patients were followed up for an average period of 15.5 months (range, 12-36 months). The average bone healing time were 2.5±0.5 months (range, 2-3 months) and 2.2±0.5 months (range, 1.5-3 months) in the plate and nail group respectively. At the latest follow-up, average VAS score was 0.4±0.6 (range, 0-2), the ASES score averaged 85.4±6.8 points (range, 73-96), Constant-Murley score averaged 83.4±7.3 points (range, 71-94), and external rotation averaged 30.8°±10.0° (range, 10°-50°) in plate group, while average VAS score was 0.2±0.4 (range, 0-1), ASES score averaged 89.7±5.6 points (range, 80-98), Constant-Murley score averaged 88.5±6.8 points (range, 76-98), and external rotation averaged 40.3°±7.9° (range, 20°-50°) in the intramedullary nailing group. One case had partial necrosis of humeral head in the plate group, while 1 case suffered absorption of the greater tuberosity in the nail group, with the complication rate of 5.6% (1/18) and 5.3% (1/19) respectively, without significant difference. The internal and external rotation degrees, ASES and Constant-Murley scores were better in nail group than those in plate group for 2-part fractures, while the forward elevation and abduction degrees were similar. Conclusion Similar results were achieved for the treatment of proximal humeral fractures by Phlios plate and Multiloc nail. The Multiloc nailing group had achieved superior outcomes in Neer-2-part proximal humeral fractures. Key words: Shoulder fractures; Internal fixators; Fracture fixation, intramedullary