Comparison between minimally invasive, percutaneous osteosynthesis and locking plate osteosynthesis in 3-and 4-part proximal humerus XXXX .

@entity6342 @entity1 @entity174 @entity158
BACKGROUND: The ideal method for the surgical treatment of @entity6342 has not yet been found. We therefore conducted a retrospective matched-pair analysis and compared osteosynthesis with open reduction and internal fixation and that with an angular stable plate with minimally invasive, closed reduction, percutaneous fixation with the Humerusblock. METHODS: During a study period of 3  years, we matched 30 @entity1 treated with angular stable plates (group 1) for age, gender, fracture type and handedness (dominant or nondominant) to 30 @entity1 treated using the Humerusblock (group 2). At a minimal follow-up of 24  months, clinical evaluation included the Constant-Murley score, the UCLA score and the Simple Shoulder Test. Subjective @entity158 was evaluated using the VAS @entity158 scale. @entity1 were asked to rate their subjective satisfaction of final outcome as excellent, good, satisfied or dissatisfied. RESULTS: The mean CMS, UCLA score and SST differed significantly between groups 1 and 2 (60.9 vs 71.9, p   <   0.01), (25.1 vs 29.5, p   <   0.01) and (8.1 vs 9.4, p   <   0.05), respectively. The VAS @entity158 score was significantly lower in group 2 than in group 1 (1.2 vs 2.4; p   <   0.01). The mean abduction (109.7   vs 133.7  ; p   <   0.01) and anterior flexion (128.3   vs 145.7  ; p   <   0.01) were significantly worse in group 1. The mean operation time was significantly shorter in group 2 (117.3 vs 72.1, p   <   0.01). Complications occurred in 30  % (group 1) and 23  % (group 2) of @entity1 . CONCLUSIONS: In this study, the functional outcome is superior in the Humerusblock group. However, the general outcome after surgical treatment of 3-and 4-part @entity174 is moderate, and the complication rate has to be considered, even though it can be lowered with the use of minimally invasive implants.
