Plates vs nails in humeral shaft fractures, Do plates lead to better shoulder function?

Abstract Background The purpose of this study was to compare shoulder final outcomes and function after humeral shaft fractures treated with plates and screws vs antegrade nailing. Materials and methods A group of 27 patients treated with plates and a group 30 patients (previously published) who underwent antegrade locked intramedullary nailing, all with acute humeral shaft fractures, were retrospectively compared. Final shoulder range of motion (ROM), full shoulder ROM recovery rate, functional outcomes, residual pain, complications and elbow flexion extension range were also analyzed. Results There were 57 patients in all, 27 cases in the plates group (P) and 30 in the nails one (N) . (average age, 41.9). There were 66.7% males in group N and the 63.0% in group P. The median age was of 38 (interquartile range (IQR) 28) in group N and 37 years (IQR 55) in group P. There were no differences in follow-up between groups, median 28 months ( RI 7) in group P, and median 30 months (RI 2) in group N (p 0.385). There was no difference in both groups in the elbow flexion extention. P group had shoulder full range of motion (66.6% vs 40.0% p=0.02) and excellent Rodriguez –Merchan scoring(66% vs 40.0% p Conclusions Plates treatment in this comparative study lead to better range of motion in the shoulder and fewer complications. Some degrees of shoulder motion decrease is expected after humeral shaft osteosynthesis. However, the functional scores and the healing index can be good and excellent with both techniques.