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            [0] => Plates Versus Intramedullary Nails For The Treatment Of Proximal Humeral Fractures: A Comparative Study.
        )

    [etablissement] => Array
        (
            [0] => hôpital FSI la Marsa
        )

    [nom] => Array
        (
            [0] => BEN ROMDHANE
        )

    [prenom] => Array
        (
            [0] => Majdi
        )

    [email] => Array
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            [0] => majdi.benromdhane@fmt.utm.tn
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            [0] => 22635981
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            [0] => 
 
Nom prénom / Name Surname: Zaafouri Akram
Email: zaafouri1994@gmail.com
Hôpital / Hospital: hôpital FSI la Marsa

 
Nom prénom / Name Surname: Ben Romdhane Majdi
Email: majdi.benromdhane@fmt.utm.tn
Hôpital / Hospital: hôpital FSI la Marsa

 
Nom prénom / Name Surname: Kamoun Haithem
Email: haithem.kamoun@fmt.utm.tn
Hôpital / Hospital: hôpital FSI la Marsa

 
Nom prénom / Name Surname: Sghaier Majdi
Email: sgh.majdi@gmail.com
Hôpital / Hospital: hôpital FSI la Marsa

 
Nom prénom / Name Surname: elafram rafik
Email: rafik.elafram@gmail.com
Hôpital / Hospital: hôpital FSI la Marsa

        )

    [mots_cles] => Array
        (
            [0] => Humerus, Plate, Nail, Comparative;

        )

    [event-id] => Array
        (
            [0] => 3663
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    [statut] => Array
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            [0] => 1
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            [0] => none
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    [user_email] => Array
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            [0] => majdi.benromdhane@fmt.utm.tn
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    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Background
Proximal humeral fractures are common injuries which incidence is in constant increase. Although various treatment options have been described, the management of these fractures remains challenging giving the lack of consensus. The aim of our study was to compare functional and radiological outcomes of plates (PL) and intramedullary nails (IM) in order to suggest treatment guidelines.
 

Objectives
The aim of our work was to study the functional and radiological outcomes of reverse total shoulder arthroplasty following complex fractures of the upper extremity of the humerus, and to compare our results with those reported in the litterature.

Study Design & Methods
A retrospective and comparative study was led among 50 cases of proximal humeral fractures (IM=31, PL=19) that occurred between January 2012 and December 2016. Fractures were classified according to NEER classification. Radiological assessments were performed immediately after surgery, in the early postoperative and at last follow-up. Absolute and relative Constant scores were used to assess shoulder function at the last decline. The minimal follow-up time undertaken was 9 months.
 

Results
The mean age was 51.9 years in the IM group and 50.7 years in the LP group. The average operative time was significantly higher in the LP group. No statistically significant differences could be found between the two groups regarding synthesis quality, anatomical reduction quality and mean time to union. We observed a trend toward better shoulder function, better anatomical outcomes, and lower complication rate in the IM group for two-part proximal humeral fractures without reaching statistical significance. Intramedullary nailing and plate fixation yielded similar radiological and functional outcomes in patients with three-part fractures. The majority of patients with four-part fractures were treated by plate fixation and achieved satisfactory results.
 

Conclusions
Intramedullary nailing is the best indication for two-part proximal humeral fractures. Our results suggest that both techniques may be useful for internal fixation of three-part fractures. For four-part fractures and dislocated ones, plate osteosynthesis through the deltoid-pectoral approach represents the method of choice.
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