[Osteosynthesis for proximal humeral fractures : plate or nail ? Results of a retrospective monocentric study].

Locking intramedullary nails and locking plates are widely used. There is a lack of consensus about optimal surgical treatment. We compare these techniques. This retrospective study included 97 patients : 51 with nail, 46 with plate. Absolute and relative Constant-Murley scores and Simple Shoulder Test (SST) were used to assess postoperative function. Time of fracture union and complications were recorded. Two fragment fractures were preferentially treated by nails and 4 fragment fractures by plates. There is no difference for union except advantage for nails in 2 fragment fractures. The functional outcome is similar, relative Constant-Murley score is 72,7 ± 0,3 %, SST 6,7 ± 3,9 after nailing and relative Constant-Murley score is 65,4 ± 0,3 %, SST 6,0 ± 3,6 after plating. Number of complications is similar after plating (67,4 %) and nailing (62,7 %). We propose to promote nailing for 2 fragment fractures and treatment with plates for 4 fragment fractures. Three fragment fractures can be treated by both techniques.