Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly.

Abstract:

Purpose:The incidence of proximal humeral fractures is high in the elderly, and the superior management of these fractures remains a controversy. The study aims to compare clinical outcomes of intramedullary nails, locking plates and conservative treatment for the management of displaced proximal humeral fractures in the elderly. Patients and methods:In this prospective study, a total of 198 patients with 2- or 3-part proximal humeral fractures who received fixation of locking plates or intramedullary nails or conservative treatment were included. The primary outcome was the 24-month Constant-Murley score. The secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) scores, the visual analog scale (VAS) pain scores, shoulder range of motion and complication rate. Results:There were no statistically significant differences in the Constant-Murley scores and ASES scores among the plate group, the nail group and the conservative group for 2-part fractures. For 3-part fractures, Constant-Murley scores and ASES scores were lower in the conservative group compared with those in the plate group and the nail group. Besides, the conservative group showed a significantly lower external rotation during follow-ups. The complication rate was comparable among the plate group, the nail group and the conservative group for both 2-part and 3-part fractures. Conclusion:Similar satisfactory functional outcomes can be achieved with the locking plates, intramedullary nails or conservative treatment for 2-part proximal humeral fractures in the elderly. The advantages in functional outcomes favor locking plates and intramedullary nails in the management of 3-part proximal humeral fractures.

journal_name

Clin Interv Aging

authors

Ge W,Sun Q,Li G,Lu G,Cai M,Li S

doi

10.2147/CIA.S144084

subject

Has Abstract

pub_date

2017-11-29 00:00:00

pages

2047-2054

eissn

1176-9092

issn

1178-1998

pii

cia-12-2047

journal_volume

12

pub_type

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