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A comparative study of locking plate combined with minimally invasive plate osteosynthesis and intramedullary nail fixation in the treatment of Neer classification of two-part and three-part fractures of the proximal humerus

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

To compare the clinical efficacy of the minimally invasive locking plate technique (Philos plate) and interlocking intramedullary nailing technique (TRIGEN intramedullary nail) in the treatment of Neer two-part and three-part proximal humeral fractures.

Methods and materials

The clinical data of 60 patients with Neer two-part and three-part proximal humerus fractures admitted to the hospital from April 2017 to April 2021 were retrospectively analyzed. Thirty-two patients were treated with the minimally invasive locking plate technique (minimally invasive plate group), and 28 patients were treated with the interlocking intramedullary nailing technique (intramedullary nail group). The operation time, intraoperative blood loss, incision length, fracture healing time, and postoperative complications were compared between the two groups. The ASES score and Constant–Murley score were used to evaluate the shoulder joint function of the two groups one year after surgery.

Results

All 60 patients were followed up for 12 to 24 months, with an average of 16 months. There was no significant difference in operation time, intraoperative blood loss, incision length, or fracture healing time between the two groups (P > 0.05). The incidence of postoperative complications in the intramedullary nail group was significantly lower than that in the minimally invasive steel plate group, and the difference between the groups was statistically significant (P < 0.05). There was no significant difference in the ASES score or Constant–Murley score between the two groups one year after surgery (P > 0.05).

Conclusion

The use of the minimally invasive locking plate technique and interlocking intramedullary nailing technique in the treatment of Neer two-part and three-part proximal humerus fractures has the advantages of a small incision, less blood loss, and a high fracture healing rate, and both can achieve satisfactory clinical effects. The internal nail technique is more convenient than the minimally invasive locking plate technique in controlling postoperative complications.

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Availability of data and materials

The datasets analyzed during the current study are not publicly available due privacy but are available from the corresponding author on reasonable request.

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Acknowledgements

The work is supported by the National Science Fund Project (No. 82172431).

Funding

The work is supported by the National Science Fund Project (No. 82172431).

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Author notes

  1. Xiang Zhu, Chen Ding, and Ya Zhu are contributed equally.

Authors and Affiliations

  1. Department of Orthopedics, Changhai Hospital, Naval Military Medical University, 168 Changhai Road, Shanghai, China

    Xiang Zhu, Chen Ding, Shensheng Nian & Hao Tang

  2. Department of Orthopedics, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an, Huai’an, 223003, Jiangsu Province, China

    Ya Zhu

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  1. Xiang Zhu
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  2. Chen Ding
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  3. Ya Zhu
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Contributions

XZ, CD, and YZ contributed to the conception and design of this study, the performance of experiments, interpretation, data analysis, and manuscript writing. SN and HT contributed to the design of this study, acquiring financial support, data analysis, interpretation, manuscript writing, and the final approval of the manuscript.

Corresponding authors

Correspondence to Shensheng Nian or Hao Tang.

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The authors declare that they have no conflict of interest.

Ethical approval and consent to paticipate

This study was approved by the Medical Research Ethics Board of the Changhai Hospital of Naval Military Medical University, which waived the need for written informed consent due to the retrospective nature of the study. All methods were carried out in accordance with relevant guidelines and regulations. All experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki).

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Zhu, X., Ding, C., Zhu, Y. et al. A comparative study of locking plate combined with minimally invasive plate osteosynthesis and intramedullary nail fixation in the treatment of Neer classification of two-part and three-part fractures of the proximal humerus. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03996-6

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  • DOI: https://doi.org/10.1007/s00590-024-03996-6

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