A Comparative Analysis of the Efficacy and Safety of Locking Compression Plate and Interlocking Intramedullary Nail for Proximal Humerus Fractures in the Elderly

ZANG Xiliang; SHEN Linhua; WANG Zuofeng; CAI Chengming; WANG Xiaojun; SONG Tao; WU Chengbo

doi:10.3639/j.issn.2095-3097.2025.07.011

Abstract：Objective To compare the efficacy and safety of locking compression plate(LCP)and interlocking intra-medullary nail(IMN)for internal fixation of proximal humerus fractures in the elderly.Methods A retrospective analysis was conducted on clinical and follow-up data of elderly patients with proximal humeral fractures admitted to the 970th Hos-pital of the Joint Service Support Force of the Chinese People's Liberation Army from September 2021 to September 2024.Using a continuous case collection method,76 patients treated with LCP internal fixation from September 2021 to March 2023 were selected as the control group,and 76 patients treated with IMN internal fixation from April 2023 to September 2024 were included as the study group.General data,clinical efficacy,surgical-related indicators,Constant-Murley score,visu-al analogue scale(VAS),inflammatory factor levels,and complications were compared between the two groups.Results At 6 months postoperatively,the total effective rate of the study group was 96.05%,significantly higher than that of the control group(81.58%),and the difference was statistically significant(P<0.05).The study group had shorter operation time,less in-traoperative blood loss,shorter postoperative hospital stay,and shorter fracture healing time compared to the control group[(112.75±10.36)min vs(135.89±7.34)min,(123.54±15.23)mL vs(185.06±11.89)mL,(4.21±0.72)d vs(7.19±0.86)d,(12.25±1.09)weeks vs(14.92±0.83)weeks,P<0.05].At 1 month and 6 months postoperatively,the Constant-Murley score of the study group was higher than that of the control group,while the VAS score was lower,and the difference was statistically significant(P<0.05).At 24 h and 72 h postoperatively,the levels of PCT and CRP in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total complication rate in the study group was 3.95%,significantly lower than that in the control group(19.74%),and the difference was statistically significant(P<0.05).Conclusion Compared with LCP internal fixation,IMN internal fixation for proximal humerus fractures in the elderly demon-strates superior efficacy,improves surgical-related indicators,promotes recovery of shoulder joint function,results in less post-operative pain and lower inflammation levels,and offers better safety.