Treatment of humerus surgical neck fracture with interlocking intramedullary nail versus locking plate

Abstract

Objective To compare efficacy between the interlocking intramedullary nail and the locking plate in the treatment of humerus surgical neck fractures.Methods From January 2003 through June 2008,36 patients with humerus surgical neck fracture were randomized into an interlocking intramedullary nail group (21 cases ) and a locking plate group ( 15 cases).They were 11 males and 25 females,with an average age of 60.3 years (range,26 to 78 years).According to the Neer system,there were 6 cases of type Ⅱ,13 cases of type Ⅲ and 2 cases of type IV in the nail group,while there were 4 cases of type Ⅱ,8 cases of type Ⅲ and 3 cases of type IV in the plate group.The data of wound length,operative time,intra-operative blood loss,fracture healing time and functional recovery were recorded and analyzed statistically.Results The follow-up periods ranged from 6 to 24 months (average,15.3 months).There were significant differences between the 2groups( P ＜ 0.05 ) in wound length,operative time and intra-operative blood loss,but the average fracture healing time was not significantly different between the groups( P ＞ 0.05).The functional recovery was better in the intramedullary nail group than in the locking plate group but with no significance( P ＞ 0.05).Conclusion Although both theinterlocking intramedullary nail and the locking plate are similarly effective in the treatment of humerus surgical neck fractures,the former has an advantage in operative invasion and manipulative simplicity. Key words: Hurneral fractures, proximal; Fracture fixation, internal; Treatment outcome