Publication:

Study on the efficiency of locking plate surgery with that of inter locking nail treatment in management of proximal humerus fracture in P. T. Birta City Hospital and Research Center

Background Proximal humeral fractures (PHFs) commonly exhibit a bimodal distribution based on trauma energy levels, affecting mainly those over 65 through low-energy falls, often indicating osteoporosis. Treatment approaches for displaced PHFs vary, with locking plates offering high stability but posing risks to blood supply and nerves. The efficacy of surgical versus conservative treatments remains debated, especially for complex fractures, with studies linking surgical options like intramedullary nailing and locking plates to mixed outcomes, including possible shoulder limitations. Aims and objectives were to evaluate the efficiency of locking plate surgery with that of interlocking nail in treatment in management of PHF.

Methods A prospective investigation was carried out on patients who visited our hospital's outpatient department. A general anaesthetic and brachial plexus block were delivered throughout the patients' procedures. Each operation was performed by the same team, which was proficient in both approaches. The study conducted t-test and Chi-square to analyze the data.

Results The analysis found no significant demographic differences between the two groups (p>0.05). The non-operative group had significantly lower blood loss (71.8±10.5 ml) than the locking plate group (134.2±16.9 ml, p=0.000). Visual analog score (VAS) and Constant-Murley scores indicated greater shoulder function improvements for the locking plate group at three months (p 0.05). Postoperative complications did not significantly differ between groups (p=0.337).

Conclusions Locking plates reduce fractures faster than interlocking intramedullary nails. Both internal fixation techniques for proximal humerus fracture had similar pain and shoulder function scores.