The inclusion criteria were as follows: (1) patients older than 18 years of age who consented to undergo surgery, and those able to actively cooperate with functional rehabilitation exercises after surgery (2) patients with a good general condition who were able to tolerate anesthesia and surgery and (3) patients treated for OTA/AO type 11C1.1 and 11C3.1 proximal humerus neck fractures. We retrospectively analyzed the data collected from patients with proximal humerus fractures who underwent surgical treatment in our hospital from June 2012 to June 2017. To address this knowledge gap, we conducted a retrospective analysis comparing the clinical efficacy of locking plate and intramedullary nail fixations for OTA/AO type 11 C proximal humerus anatomical neck fractures. Currently, there are no studies comparing the efficacy and safety of locking plate and intramedullary nail fixations in the treatment of OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures. On the contrary, proximal humerus locking intramedullary nails have become increasingly popular with orthopedic physicians because of their minimally invasive insertion and good stability. However, the use of locking plates in the treatment of proximal humerus fractures carries a high risk of complications, such as humeral head varus, screw penetrations, and internal fixation loosening. Locking plate fixation remains the gold standard for the treatment of proximal humerus fractures. OTA/AO type C proximal humerus fractures remain particularly challenging to treat due to these above-mentioned factors, in addition to difficulties in managing bone voids that remain after fracture reduction. Patient factors, such as reduced local bone density, incomplete medial calcar support, and humeral head ischemia, may all precipitate these failures, in addition to surgeon-related factors, including inadequate fracture reduction and postoperative displacement. Proximal humerus fractures, particularly anatomical neck fractures in older adults, are prone to failure of internal fixation, commonly resulting in poor prognosis and shoulder function. However, intramedullary nailing has advantages over locking plates for OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures in terms of operation time and bleeding volume. Similar satisfactory functional results can be achieved with locking plates and intramedullary nailing for OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures, with no significant difference in the number of complications between these two techniques. Complications, including screw penetrations, acromion impingement syndrome, infection, and aseptic necrosis of the humeral head, occurred in 8 patients (8/35, 22.8%) in the locking plate group and 5 patients in the intramedullary nail group (5/33, 15.1% including malunion and acromion impingement syndrome), with no significant difference between the groups ( P > 0.05). The mean operation time of the locking plate group was significantly longer than that of the intramedullary nail group ( P 0.05). The total cohort had a mean follow-up duration of 17.8 months. Overall, 35 patients underwent open reduction and plate screw internal fixation, and 33 patients underwent limited open reduction and locking of the proximal humerus with intramedullary nail internal fixation. Sixty-eight patients with OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures were enrolled in this study. Perioperative indicators, postoperative morphological parameters of the proximal humerus, and Constant–Murley scores were evaluated and compared. We retrospectively analyzed the data of patients with OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures who underwent surgery at our institution from June 2012 to June 2017. This study aimed to compare the clinical efficacy of locking plate and intramedullary nail fixations in the treatment of patients with OTA/AO type 11C proximal humerus fractures.
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