This retrospective study compares the clinical outcomes of the Minimally Invasive Reduction and Osteosynthesis System (MIROS) and intramedullary nailing (IMN) in treating isolated surgical neck fractures of the humerus. A total of 42 patients were included, with 18 treated using MIROS and 24 with IMN. The primary outcomes assessed were the complication rates, functional recovery (DASH score), pain levels (VAS), and radiological healing. The MIROS group exhibited a higher complication rate (22.2% vs. 8.8%), with K-wire migration and superficial infections being the most frequent. Patients treated with MIROS reported lower postoperative pain (VAS 45 ± 25.7) compared to the IMN group (VAS 58.1 ± 12.5). Both groups demonstrated radiological healing within three months, but one MIROS patient required reoperation due to hardware failure. No significant differences were observed in the DASH scores between the groups. Our findings suggest that IMN is a preferable treatment option for younger patients with good bone quality, while MIROS may still be beneficial for elderly patients with significant comorbidities, albeit with a higher risk of complications. Future prospective studies are recommended to confirm these findings.
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