Comparison of efficacy of intramedullary nail and locking proximal humeral plate in the treatment of proximal humeral fractures
XIONG Hui
TIAN Haochao
HAN Huaqiang
LI Peng
ZHENG Baojun
Abstract：Objective To compare the efficacy of intramedullary nail(IN)and locking proximal humeral plate(LPHP)in the treatment of proximal humeral fractures(PHF).Methods Clinical data of 86 patients with PHF admitted to Kaifeng Second Traditional Chinese Medicine Hospital from May 2021 to May 2023 were retrospectively analyzed.They were divided into two groups according to the different procedures,patients in observation group underwent IN fixation(n=43),while patients in control group underwent LPHP fixation(n=43).Surgery-related indicators and postoperative recovery conditions were evaluated,preoperative and postoperative serum malondialdehyde(MDA),superoxide dismutase(SOD),and bone alkaline phosphatase(BALP)levels were observed,shoulder joint function,Constant-Murley scores,visual analog scale(VAS)scores,as well as postoperative complications were compared between the two groups.Results Operation time[(86.13±10.68)min],incision length[(5.29±2.28)cm],and hospitalization days[(7.36±2.89)d]in observation group were shorter than those in control group[(93.50±10.62)min,(7.40±2.22)cm,and(10.51±2.80)d,respectively].Intraoperative blood loss[(131.52±10.53)mL]in observation group was less than that in control group[(156.45±10.45)mL].At 2 d postoperatively,the level of MDA[(2.53±0.14)μ mol/L]in observation group was lower than that in control group[(2.89±0.21)μmol/L],and the levels of SOD[(163.11±15.60)KU/L]and BALP[(78.65±5.48)U/L]were higher than those in control group[(151.03±15.41)KU/L and(70.31±5.51)U/L,respectively].Range of motion(ROM)of passive forward flexion[(129.43±15.51)degree],external abduction[(137.13±13.33)degree],and external rotation[(35.08±5.20)degree]of the shoulder joint at one month after surgery,as well as Constant-Murley score[(71.15±5.86)points]at 3 months postoperatively in observation group were higher than those in control group[(121.76±15.48)degree,(130.42±13.21)degree,(30.12±5.11)degree,and(66.12±5.77)points,respectively].Total incidence of postoperative complications in observation group(4.65%)was lower than that in control group(30.23%).Differences of the above indicators between two groups showed statistically significant(all P<0.05).Conclusion Compared with LPHP fixation,IN fixation in the treatment of PHF patients could shorten operation time,reduce estimate intraoperative blood loss,relieve oxidative stress,improve the shoulder joint function and reduce the incidence of postoperative complications.
Keywords：Proximal humeral fractureFracture fixationIntramedullary nailLocking plateShoulder joint functionOxidative stress
Publication Date：2024-06-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 177-182 )