To compare the efficacy of locking plate versus interlocking intramedullary nail in the treatment of Neer type 2 and 3 partial humeral fractures.

The clinical data of 89 cases of humeral fractures were retrospectively analyzed, including 52 cases in locking plate group and 37 cases in intramedullary nail group, 37 males and 52 females, with an average age of (57.7±7.1) years. 61% (50/82) of fractures were caused by falls.There was no statistically significant difference between the two groups in terms of demographics, comorbidities, and injury characteristics. The medical records, operative reports and follow-ups of the patients were reviewed. The surgical incision, operation time, intraoperative bleeding, hospital stay, time required for fracture healing, as well as the shoulder joint function, range of motion and complications during the follow-ups at 1, 3, 6 and 12 months postoperatively were recorded. Statistical description and analysis were performed using SPSS 25.0.

Patients were followed up for (14.1 ± 3.6) months (12 to 21 months). For surgical parameters, the intramedullary nail group performed significantly better than the locking plate fixation group, and the differences were statistically significant: incision length (6.7±2.7 cm vs. 11.6±3.8 cm, P=0.001), operation time (104±37 mins vs. 138±47 mins, P=0.001), and blood loss (158±114 ml vs 336±185 ml, P<0.001). Intramedullary nailing with locking plate group had significant advantage in early recovery [ASES score 69±7 vs. 59±9, Constant-Murley score 62±8 vs 51±7 at 3 months, ASES score 84±6 vs 72±9, Constant-Murley score 76±7 vs 71±7, external rotation (42±6)° vs (36°±7)° at 6 months], with all P<0.05, at last follow-up, there was no statistical difference in functional score and range of motion between the two groups.

Intramedullary fixation is superior to locking plate fixation in the treatment of 2 and 3 part humeral fractures in terms of surgical parameters and early functional recovery. Intramedullary fixation can be recommended for patients with particular needfor early functional recovery.