Comparative analysis of operative treatment of fractures of the proximal humerus using two different surgical techniques




Srđan Ninković, Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Vojvodina; Department of Surgery, Faculty of Medicine, University of Novi Sad. Novi Sad, Serbia
Nataša Janjić, Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Vojvodina; Department of Surgery, Faculty of Medicine, University of Novi Sad. Novi Sad, Serbia
Nikola Vukosav, Faculty of Medicine, University of Novi Sad; Clinic for orthopedic surgery and traumatology, Clinical Center of Vojvodina. Novi Sad, Serbia
Milan Milinkov, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Oliver Dulić, Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Vojvodina; Department of Surgery, Faculty of Medicine, University of Novi Sad. Novi Sad, Serbia
Predrag Rašović, Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Vojvodina; Department of Surgery, Faculty of Medicine, University of Novi Sad. Novi Sad, Serbia


Objective: The purpose of this study was to examine the surgical treatment of two-part and three-part proximal humerus fractures utilizing two approaches. Method: Study involved a total of 40 individuals. Twenty patients were treated with plates and screws and 20 with intramedullary locking nail osteosynthesis. We created 10 pairs of patients that were matched in age, gender, and fracture type, with the sole difference being the osteosynthetic material used. The mean follow-up was 4 years (1-9 years). We evaluated the results of treatment using Constant’s scoring scale. Results: The mean value of Constant’s scoring scale was 78.05 for patients treated with plates and screws and 67.55 for those treated with intramedullary stabilization. There was no statistically significant difference between the groups nor were there statistically significant differences in postoperative range of motion (ROM). Conclusions: The results of Constant’s scoring scale were higher for patients whose fractures were stabilized with a plate and screws. The same group of patients had a higher degree of mobility and better ROM. Even while there was a general tendency toward better outcomes when using plates and screws for fixation, there was no indication as to which surgical technique offers the best results.



Keywords: Shoulder. Humeral head. Shoulder fractures. Intramedullary nailing. Internal fracture fixation.