Straight Proximal Humeral Nailing Can Avoid Deltoid Atrophy for Proximal Humeral Fracture: A Comparison with Locking Plating

Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea

*Corresponding author: Jae-Sung Yoo, M.D., Department of Orthopaedic Surgery, Dankook University College of Medicine, Manghyangro 201, Dongnam-gu, Cheonan, Chungnam 330-715, Republic of Korea; Tel: 82-41-550-3060; Fax: 82-41-556-3238; E-mail: [email protected]

Received Date: December 21, 2022

Publication Date: January 4, 2023

Citation: Joong-Bae Seo, et al. (2023). Straight Proximal Humeral Nailing Can Avoid Deltoid Atrophy for Proximal Humeral Fracture: A Comparison with Locking Plating. Orthop Res J. 5(1):25.

Copyright: Joong-Bae Seo, et al. © (2023)

ABSTRACT

Background: Open reduction and plate fixation are the main surgical treatment methods for proximal humeral fracture. However, it is difficult to avoid iatrogenic deltoid insertion injuries while ensuring a proper plate position. We aimed to compare the deltoid muscle volume in treating proximal humerus fractures using the locking compression plate (LCP) and intramedullary (IM) nail fixation methods. Methods: Fifty-two consecutive patients who underwent surgical fixation for proximal humerus fractures were included in the present study. The participants were divided into two groups: the LCP fixation group and the straight IM nail fixation group. Results: No statistically significant differences were detected in the clinical outcomes between these groups. In the 12th week postoperatively, the union rate was much higher in the IM nail group (87.5%) than that in the LCP group (78.5%; p = 0.011). The deltoid volume ratio (%) was significantly higher in the IM nail group (97.5%) than in the LCP group (91.2%; p = 0.003). Conclusion: When treating proximal humerus fractures, straight IM nail fixation revealed convincing outcomes; thus, it could be a useful treatment option for early bony union and to avoid iatrogenic deltoid insertion injuries compared to LCP fixation.

Level of evidence: Level III, retrospective study.

Keywords: Proximal humeral fracture, Locking plate fixation, Intramedullary fixation, Deltoid