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ANTEGRADE NAILING VERSUS LOCKING PLATE OF 2-AND 3-PART PROXIMAL HUMERUS FRACTURES

OBJECTIVE: To evaluate and compare the proportions of complications and radiographic findings of osteosynthesis of 2- and 3-part proximal humerus fractures with two methods of treatment: third-generation antegrade nailing and locking plate. METHODS: 46 patients with a mean age of 58.9 ± 16.6 years b...

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Detalles Bibliográficos
Autores principales: GOMES, GUSTAVO REMIGIO, MACIEL, RAFAEL ALMEIDA, ALMEIDA NETO, JOSÉ INÁCIO DE, TOLEDO, DANIEL CARVALHO DE, MACHADO, CARLA JORGE, BOMFIM, LEONIDAS DE SOUZA
Formato: Online Artículo Texto
Lenguaje:English
Publicado: ATHA EDITORA 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670793/
https://www.ncbi.nlm.nih.gov/pubmed/36451783
http://dx.doi.org/10.1590/1413-785220223005e256113
Descripción
Sumario:OBJECTIVE: To evaluate and compare the proportions of complications and radiographic findings of osteosynthesis of 2- and 3-part proximal humerus fractures with two methods of treatment: third-generation antegrade nailing and locking plate. METHODS: 46 patients with a mean age of 58.9 ± 16.6 years between January 2020 and January 2021 were evaluated. In sixteen cases (34.8%), antegrade nailing was used, and in thirty cases (65, 2%), a locking proximal humerus plate. The method used included the rate of complications with a minimum follow-up of 6 months after surgery and radiographic evaluation. RESULTS: There was no difference between the groups regarding the proportion of complications (nail group 18.8%, plate group 13.3%; p = 0.681). The nail group had less residual varus loss (cervicodiaphyseal angle nail group with 132.1º ± 2.3º, plate group 123.8º ± 10.1º; p < 0.001). In the plate group, women had the lowest value (1.43 ± 0.22) of the deltoid tuberosity index (DTI) compared to men (1.58 ± 0.11) (p = 0.022). CONCLUSION: Osteosynthesis, with a locking plate and antegrade nailing, did not show differences in the proportion of complications. The nail group had less change in the postoperative cervicodiaphyseal angle, however, there were two serious complications with screw cut-out and varus deviation, requiring surgical reapproach. Level of Evidence II, Retrospective Observational Study.