gms | German Medical Science

Objectives: The extended locking straight steel plate system has been widely used in clinical treatment of complex upper and middle humeral fractures, especially in the fixation of combined proximal humeral fractures, and has achieved satisfactory therapeutic effects. In recent years, intramedullary nails and spiral steel plates have also been continuously applied in the treatment of complex upper and middle humeral fractures. This article aims to explore and analyze the comparative analysis of the therapeutic effects of spiral steel plates, intramedullary nails, and straight steel plates in the treatment of complex upper and middle humeral fractures.

Methods: Retrospective analysis of clinical data of 81 patients with complex upper humeral fractures who met the selection criteria and received follow-up from January 2018 to December 2022. Among them, 16 cases were fixed with spiral steel plates (spiral steel plate group), 12 cases were fixed with intramedullary nails (intramedullary nail group), and 53 cases were fixed with straight steel plates (straight steel plate group). There was no statistically significant difference in general information such as gender, age, cause of injury, fracture side and classification, and time from injury to surgery among the three groups of patients (P>0.05). Compare three groups of pain VAS, (ASES) score, Constant Murley score, and shoulder joint range of motion; Review the fracture healing status with X-ray film, measure the neck shaft angle on the second day after surgery and the last follow-up image, and calculate the difference.

Results and conclusion: All three groups of patients were followed up for a duration of 16–52 months, with an average of 29 months; There was no statistically significant difference in follow-up time among the three groups (p>0.05). The X-rayexamination showed no statistically significant difference in fracture healing among the three groups (p>0.05). The difference in neck shaft angle between the spiral steel plate group was (5.00 (3.25, 6.00)°, the intramedullary nail group was (4.00 (2.00, 7.75)°, and the straight steel plate group was (5.00 (3.50, 10.00)°. The difference between the three groups was not statistically significant (p<0.05). At the last follow-up, there were statistically significant differences in Constant Murley score, ASES score, VAS score, and shoulder joint range of motion among the three groups (p<0.05). The spiral steel plate group was superior to the intramedullary nail group and the straight steel plate group.Spiral steel plates, intramedullary nails, and straight steel plates can all be used to treat complex fractures of the upper and middle segments of the humerus, achieving good fracture reduction and healing.