Proximal Humerus Fractures Clinical Trial
Official title:
Randomised Study Between Intramedullary Locking Nails and Locking Plates for Treatment of Proximal Humerus Fractures in Patients After 40-year-old
Primary purpose of this study was to compare functional outcomes after displaced and
proximal humerus fracture between nails and locked plates.
The hypothesis is that intramedullary nails provides satisfactory fixation and functional
outcome compared to locked plate.
: Proximal humerus fractures have a higher occurrence in elderly patients and therefore
represent a public health problem.
Prognosis depends on greater and lesser tuberosity status, where rotator tendons of the
shoulder have their insertion site.
Surgical treatment is recommended in case of tuberosities displacement. Goals are their
anatomic reduction and stable primary fixation that will allow good bone healing and early
mobilization. It has been demonstrated that an extended immobilization can result in
stiffness by capsular retraction. On the contrary a too early mobilization can lead to
secondary displacement of tuberosities and malunion.
These sequelae can be responsible for real disability when occuring in active patients, in
particular when dominant limb is affected.
Internal fixation by locking intramedullary nails is currently the first choice technique
because less invasive. However it doesn't always provide a good bone fixation, leading to
tuberosities displacement or longer immobilization that decrease shoulder function
prognosis. Locking plates represent a good alternative to avoid these complications by
offering a better fixation of tuberosities in osteoporotic bone.
Though there is no existing randomised study comparing these techniques regarding functional
outcomes, complications rates, and patient satisfaction.
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