Locking nails linked with more complications vs. plates in proximal humerus fractures
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Key takeaways:
- Locking intramedullary nails yielded more complications and reoperations compared with locking plates.
- However, the locking nail and plate groups had no differences in DASH scores at 2-year follow-up.
SAN FRANCISCO — Although locking nails and locking plates had similar DASH scores in treatment of proximal humerus fractures, results presented here showed patients who received locking nails had more complications and reoperations.
Annette K. B. Wikerøy, MD, and colleagues randomly assigned 76 patients with displaced three- or four-part proximal humerus fractures to receive either a locking intramedullary (IM) nail (n=38) or a locking plate (n=38). Wikerøy said the DASH score was used as the primary endpoint. Secondary endpoints included the Oxford shoulder score, Constant score, complications, reoperations and VAS for pain, rest and activity. Follow-up timepoints included 6 and 12 weeks, 6 months, and 1 and 2 years.
Patients in the locking IM nail group experienced more complications compared with the locking plate group, according to Wikerøy.
“The patients with reoperations, not surprisingly, [this was] also higher in the nailing group and statistically significantly different,” Wikerøy said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
She added patients had no differences in DASH scores at 2-year follow-up, with a DASH score of 12.7 for the nailing group and 10.8 for the plating group.
“These are the normative population data from Norway. The mean age of these patients were 66 to 67 years. So if you look at the women in this age group in Norway, the normative values are 18 and men are 11,” Wikerøy said. “Not so bad results, but bear in mind that these patients had a baseline DASH score of 1 to 1.5, so they are not back to their pre-trauma values.”
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Wikerøy AKB, et al. Paper 432. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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