Comparison of Intramedullary Nails Versus Steel Plates Combined with Titanium Mesh in the Treatment of Proximal Humeral Varus Fractures
Wan Guoyang
Chen Chaoqun
Si Weibing
Zheng Bin
Qin Wei
Hao Yuefeng
Abstract：Objective To compare the treatment outcomes of MultiLoc intramedullary nails versus PHILOS plates combined with titanium mesh support for elderly patients with varus-deformed proximal humeral fractures.Methods A retrospective analysis was conducted on 70 elderly patients with complex varus-deformed proximal humeral fractures admitted to Suzhou Municipal Hospital from January 2018 to January 2023.The intramedullary nail group comprised 35 cases treated with closed reduction and MultiLoc intramedullary nail internal fixation,including 20 males and 15 females.Ages ranged from 60 to 80 years,with a mean age of(68.42±4.26)years.The locking plate group comprised 35 cases treated with open reduction and internal fixation using PHILOS locking plates combined with titanium mesh support.This group included 19 males and 16 females,aged 60 to 80 years,with a mean age of(68.71±4.53)years.The two groups were compared in terms of surgical indicators,change in hemoglobin within 24 hours postoperatively,visual analogue scale(VAS)pain score within 24 hours postoperatively,fracture healing time,Constant-Murley score,loss of cervical angle at 24 months postoperatively,shoulder joint range of motion,and incidence of complications.Results Follow-up ranged from 24 to 28 months,with a mean duration of(25.70±1.34)months.The intramedullary nail group demonstrated significantly lower intraoperative blood loss,shorter operative time,smaller 24-hour postoperative hemoglobin change,lower 24-hour postoperative VAS score,less 24-month postoperative loss of glenohumeral angle,and shorter fracture healing time compared to the locking plate group(P＜0.05).No statistically significant differences were observed between groups in 24-month postoperative flexion-abduction range of motion,external rotation and abduction angles,Constant-Murley scores,or complication rates(P＞0.05).Conclusion For elderly patients with complex varus-deformed proximal humeral fractures,both the MultiLoc intramedullary nail and the PHILOS plate combined with titanium mesh support achieved favorable outcomes.However,the former demonstrated superiority in reducing surgical trauma,shortening fracture healing time,and preventing postoperative loss of the neck-shaft angle.
Keywords：proximal humeral fractureintramedullary nailplate
Publication Date：2025-11-25
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：5( 972-976 )