Clinical and Radiologic Results Comparing the Periarticular Proximal Humerus Locking Plate and Polarus Nail for Displaced Proximal Humerus Fractures

Min,  Young Kyoung; Lee,  Seung Jun; Gwak,  Heui Chul; Kang,  Sang Woo; Suh,  Kuen Tak

doi:2017.20.4.208

Clin Shoulder Elb > Volume 20(4); 2017 > Article

Original Article

Clinics in Shoulder and Elbow 2017;20(4):208-216.
DOI: https://doi.org/10.5397/cise.2017.20.4.208 Published online December 31, 2017.

Clinical and Radiologic Results Comparing the Periarticular Proximal Humerus Locking Plate and Polarus Nail for Displaced Proximal Humerus Fractures

Young Kyoung Min, Seung Jun Lee, Heui Chul Gwak, Sang Woo Kang, Kuen Tak Suh

¹Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
²Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea. ninanojune@naver.com

Received: 23 June 2017 • Revised: 14 August 2017 • Accepted: 23 August 2017

Abstract

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures.
METHODS
Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group.
RESULTS
The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively).
CONCLUSIONS
No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).

Key Words: Humeral fractures; Proximal; Locking plate; Intramedullary nail