Randomised Study Between Intramedullary Locking Nails and Locking Plates for Treatment of Proximal Humerus Fractures

Overview

Primary purpose of this study was to compare functional outcomes after displaced and proximal humerus fracture between nails and locked plates. The hypothesis is that intramedullary nails provides satisfactory fixation and functional outcome compared to locked plate.

: Proximal humerus fractures have a higher occurrence in elderly patients and therefore represent a public health problem. Prognosis depends on greater and lesser tuberosity status, where rotator tendons of the shoulder have their insertion site. Surgical treatment is recommended in case of tuberosities displacement. Goals are their anatomic reduction and stable primary fixation that will allow good bone healing and early mobilization. It has been demonstrated that an extended immobilization can result in stiffness by capsular retraction. On the contrary a too early mobilization can lead to secondary displacement of tuberosities and malunion. These sequelae can be responsible for real disability when occuring in active patients, in particular when dominant limb is affected. Internal fixation by locking intramedullary nails is currently the first choice technique because less invasive. However it doesn't always provide a good bone fixation, leading to tuberosities displacement or longer immobilization that decrease shoulder function prognosis. Locking plates represent a good alternative to avoid these complications by offering a better fixation of tuberosities in osteoporotic bone. Though there is no existing randomised study comparing these techniques regarding functional outcomes, complications rates, and patient satisfaction.

Conditions

Interventions

Eligibility

Locations (1)

Outcomes