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Is Locking Nailing of Humeral Head Fractures Superior to Locking Plate Fixation?
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Original Article
Is Locking Nailing of Humeral Head Fractures Superior to Locking Plate Fixation?
G. Gradl1, A. Dietze1  , M. Kääb2, W. Hopfenmüller3 and T. Mittlmeier1
| (1) |
Department of Trauma and Reconstructive Surgery, University of Rostock, Schillingallee 35, D-18055 Rostock, Germany |
| (2) |
Center for Musculoskeletal Surgery, Department of Trauma and Reconstructive Surgery, Humboldt University, University Medicine Berlin Charité, Campus Virchow, Augustenburger Platz 1, D-13353 Berlin, Germany |
| (3) |
Institute for Biometrics and Clinical Epidemiology, Humboldt University, University Medicine Berlin Charité, Campus Benjamin Franklin, Hindenburgdamm 30, D-12200 Berlin, Germany |
Received: 14 October 2008 Accepted: 20 May 2009 Published online: 13 June 2009
Abstract The optimal surgical treatment of displaced proximal humeral fractures is controversial. New implants providing angular stability
have been introduced to maintain the intraoperative reduction. In a multi-institutional study, we prospectively enrolled and
followed 152 patients with unilateral displaced and unstable proximal humeral fractures treated either with an antegrade angular
and sliding stable proximal interlocking nail or an angular stable plate. Fractures were classified according to the Neer
four-segment classification. Clinical, functional, and radiographic followups were performed 3, 6, and 12 months after surgery.
Absolute and relative (to the contralateral shoulder) Constant-Murley scores were used to assess postoperative shoulder function.
Using age, gender, and fracture type, we identified 76 pairs (152 patients) for a matched-pairs analysis. Relative Constant-Murley
scores 12 months after treatment with an angular and sliding stable nail and after plate fixation were 81% and 77%, respectively.
We observed no differences between the two groups. Stabilization of displaced proximal humeral fractures with either an angular
stable intramedullary or an extramedullary implant seems suitable with both surgical treatment options.
Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
This work was performed at University of Rostock and the Campus Virchow and Campus Benjamin Franklin of Humboldt University.
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