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Operative Treatment of 2-Part Surgical Neck Fracture of the Humerus: Intramedullary Nail Versus Locking Compression Plate With Technical Consideration

 Lee, Wonyong  ;  Park, Jun-Young  ;  Chun, Yong-Min 
 JOURNAL OF ORTHOPAEDIC TRAUMA, Vol.31(9) : e270-e274, 2017 
Journal Title
Issue Date
Academic Medical Centers ; Adult ; Aged ; Bone Nails ; Bone Plates ; Cohort Studies ; Female ; Fracture Dislocation/diagnostic imaging ; Fracture Dislocation/surgery* ; Fracture Fixation, Internal/instrumentation* ; Fracture Fixation, Internal/methods ; Fracture Fixation, Intramedullary/instrumentation ; Fracture Fixation, Intramedullary/methods* ; Fracture Healing/physiology ; Humans ; Humeral Fractures/diagnostic imaging ; Humeral Fractures/surgery* ; Injury Severity Score ; Intra-Articular Fractures/diagnostic imaging ; Intra-Articular Fractures/surgery ; Male ; Middle Aged ; Pain Measurement ; Range of Motion, Articular/physiology ; Retrospective Studies ; Shoulder Fractures/diagnostic imaging ; Shoulder Fractures/surgery* ; Trauma Centers ; Treatment Outcome
OBJECTIVE: To compare the outcomes of patients who underwent either open reduction internal fixation with a locking plate and screws or closed reduction internal fixation with an antegrade intramedullary nail (IMN) for displaced surgical neck fracture of the humerus.

DESIGN: Retrospective comparative study.

SETTING: Single institute, Level-I academic trauma center.

PATIENTS AND INTERVENTION: Sixty-nine patients with 2-part surgical neck fracture of the humerus underwent either an IMN (38 patients group A) or a locked plate fixation (31 patients group B).

OUTCOMES MEASUREMENT: Pain on a visual analog scale, University of California Los Angeles (UCLA) Shoulder Score, American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM).

RESULTS: At the 2-year follow-up, there were no significant differences in the visual analog scale pain score (1.3 in group A; 0.9 in group B), ASES score (90.2 in group A; 91.9 in group B), and UCLA Shoulder Score (30.7 in group A; 31.8 in group B) between groups. Active ROM did not differ significantly between groups. There were 3 complications in the IMN group, 1 nonunion requiring autogenous iliac crest bone graft, and 2 cases of screw loosening.

CONCLUSIONS: For displaced surgical neck fractures of the humerus, both IM nailing and locked plate fixation in patients yielded satisfactory outcomes at the 2-year follow-up with no significant differences in pain or ROM between groups.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Young(박준영) ORCID logo https://orcid.org/0000-0002-4713-4036
Lee, Won Yong(이원용)
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
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