BACKGROUND
Minimally invasive intramedullary nail (IMN) fixation has gained increasing attention for proximal humerus fractures. We compared operative time, intraoperative blood loss, postoperative pain, and functional outcomes between minimally invasive IMN fixation and locking plate fixation.
MATERIAL AND METHODS
This prospective study enrolled 61 patients from January 2019 to January 2024: 36 treated via IMN (Group A) and 25 treated via locking plates (Group B). Operative time, incision length, blood loss, visual analog scale (VAS) scores, complication rates, and postoperative shoulder function were analyzed.
RESULTS
Group A had a shorter operative time, smaller incision length, less blood loss (all P=0.001); shorter hospital stay (P=0.006); lower VAS scores (P=0.04); and fewer complications (P=0.03) than Group B. Group A demonstrated better shoulder flexion at 1, 3, and 6 months (P<0.001; =0.003, 0.029). At 1, 3, 6, and 12 months, Group A showed superior external rotation, internal rotation, and abduction versus Group B (all P<0.05). The neck-shaft angle was greater and loss of humeral head height was lower in Group A at 3, 6, and 12 months (all P<0.05). Constant-Murley scores were higher in Group A at 1 and 3 months (P=0.008, 0.032); DASH scores were lower in Group A at 3 and 12 months (P=0.002, 0.009).
CONCLUSIONS
IMN fixation for proximal humerus fractures offers shorter operative time, fewer complications, and improved postoperative shoulder function, indicating superior clinical efficacy relative to locking plate fixation.

Keywords: Fracture Fixation; Intramedullary Nailing; Minimally Invasive Surgical Procedures; Orthopedics; Proximal Humeral Fractures