Comparison of Multiloc humeral intramedullary nail system and proximal humeral internal locking system in treatment of adult proximal humeral fractures / 中华创伤骨科杂志

ABSTRACT

Objective:To compare the efficacy between Multiloc humeral intramedullary nail system (Multiloc) and proximal humerus internal locking system (PHILOS) in the treatment of adult proximal humeral fractures.Methods:A retrospective analysis was conducted of the 83 adult patients with proximal humeral fracture who had been treated at Trauma Center, The Second People's Hospital of Changzhou from August 2018 to March 2021. They were 33 males and 50 females, with 45 left sides and 38 right sides injured. By the Neer classification, there were 48 two-part, 22 three-part and 13 four-part fractures. The patients were assigned into 2 groups according to different treatments: an observation group ( n=41) receiving treatment by Multiloc and a control group ( n=42) receiving treatment by PHILOS. The 2 groups were compared in terms of humeral neck shaft angles and visual analogue scale (VAS) pain scores preoperation and one month postoperation, Neer shoulder function score at the last follow-up, and incidence of adverse reactions. Results:The preoperative general data showed no statistically significant differences between the 2 groups, indicating the groups were comparable ( P>0.05). The humeral neck shaft angle (127.4°±3.6°) was recovered significantly better and the VAS pain score (1.3±0.3) was significantly lower in the observation group than in the control group (129.6°±4.5°,2.1±0.3) one month after operation ( P<0.05). The excellent to good rate by Neer score at the last follow-up (90.24%, 37/41) was significantly higher and the incidence of adverse reactions (2.44%) significantly lower in the observation group than in the control group (71.43%, 30/42 and (19.05%, 8/42) ( P<0.05). Conclusion:In the treatment of adult proximal humeral fractures, compared with PHILOS, the Multiloc system is more effective in improving shoulder joint function, promoting shoulder motion recovery and reducing pain.