Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly

Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly

Wei Ge,* Qi Sun,* Gen Li, Guanghua Lu, Ming Cai, ShaoHua Li Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Purpose: The incidence of proxima...

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Autores principales: Ge W, Sun Q, Li G, Lu G, Cai M, Li S
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2017
Materias:
proximal humeral fractures
intramedullary nails
locking plates
conservative treatment
the elderly
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/af37030ba3474120a60e7439d2416b8e
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spelling oai:doaj.org-article:af37030ba3474120a60e7439d2416b8e2021-12-02T00:22:01ZEfficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly1178-1998https://doaj.org/article/af37030ba3474120a60e7439d2416b8e2017-11-01T00:00:00Zhttps://www.dovepress.com/efficacy-comparison-of-intramedullary-nails-locking-plates-and-conserv-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Wei Ge,* Qi Sun,* Gen Li, Guanghua Lu, Ming Cai, ShaoHua Li Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Purpose: The incidence of proximal humeral fractures is high in the elderly, and the superior management of these fractures remains a controversy. The study aims to compare clinical outcomes of intramedullary nails, locking plates and conservative treatment for the management of displaced proximal humeral fractures in the elderly. Patients and methods: In this prospective study, a total of 198 patients with 2- or 3-part proximal humeral fractures who received fixation of locking plates or intramedullary nails or conservative treatment were included. The primary outcome was the 24-month Constant–Murley score. The secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) scores, the visual analog scale (VAS) pain scores, shoulder range of motion and complication rate. Results: There were no statistically significant differences in the Constant–Murley scores and ASES scores among the plate group, the nail group and the conservative group for 2-part fractures. For 3-part fractures, Constant–Murley scores and ASES scores were lower in the conservative group compared with those in the plate group and the nail group. Besides, the conservative group showed a significantly lower external rotation during follow-ups. The complication rate was comparable among the plate group, the nail group and the conservative group for both 2-part and 3-part fractures. Conclusion: Similar satisfactory functional outcomes can be achieved with the locking plates, intramedullary nails or conservative treatment for 2-part proximal humeral fractures in the elderly. The advantages in functional outcomes favor locking plates and intramedullary nails in the management of 3-part proximal humeral fractures. Keywords: proximal humeral fractures, intramedullary nails, locking plates, conservative treatment, the elderlyGe WSun QLi GLu GCai MLi SDove Medical Pressarticleproximal humeral fracturesintramedullary nailslocking platesconservative treatmentthe elderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 2047-2054 (2017)
institution DOAJ
collection DOAJ
language EN
topic proximal humeral fractures
intramedullary nails
locking plates
conservative treatment
the elderly
Geriatrics
RC952-954.6
spellingShingle proximal humeral fractures
intramedullary nails
locking plates
conservative treatment
the elderly
Geriatrics
RC952-954.6
Ge W
Sun Q
Li G
Lu G
Cai M
Li S
Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
description Wei Ge,* Qi Sun,* Gen Li, Guanghua Lu, Ming Cai, ShaoHua Li Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Purpose: The incidence of proximal humeral fractures is high in the elderly, and the superior management of these fractures remains a controversy. The study aims to compare clinical outcomes of intramedullary nails, locking plates and conservative treatment for the management of displaced proximal humeral fractures in the elderly. Patients and methods: In this prospective study, a total of 198 patients with 2- or 3-part proximal humeral fractures who received fixation of locking plates or intramedullary nails or conservative treatment were included. The primary outcome was the 24-month Constant–Murley score. The secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) scores, the visual analog scale (VAS) pain scores, shoulder range of motion and complication rate. Results: There were no statistically significant differences in the Constant–Murley scores and ASES scores among the plate group, the nail group and the conservative group for 2-part fractures. For 3-part fractures, Constant–Murley scores and ASES scores were lower in the conservative group compared with those in the plate group and the nail group. Besides, the conservative group showed a significantly lower external rotation during follow-ups. The complication rate was comparable among the plate group, the nail group and the conservative group for both 2-part and 3-part fractures. Conclusion: Similar satisfactory functional outcomes can be achieved with the locking plates, intramedullary nails or conservative treatment for 2-part proximal humeral fractures in the elderly. The advantages in functional outcomes favor locking plates and intramedullary nails in the management of 3-part proximal humeral fractures. Keywords: proximal humeral fractures, intramedullary nails, locking plates, conservative treatment, the elderly
format article
author Ge W
Sun Q
Li G
Lu G
Cai M
Li S
author_facet Ge W
Sun Q
Li G
Lu G
Cai M
Li S
author_sort Ge W
title Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
title_short Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
title_full Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
title_fullStr Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
title_full_unstemmed Efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
title_sort efficacy comparison of intramedullary nails, locking plates and conservative treatment for displaced proximal humeral fractures in the elderly
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/af37030ba3474120a60e7439d2416b8e
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