Objective: To compare the outcomes of patients who underwent either open reduction internal fixation with a locking plate and screws or closed reduction internal fixation with an antegrade intramedullary (IM) nail for displaced surgical neck fracture of the humerus.

Design: retrospective comparative study

Setting: single institute, Level-I academic trauma center

Patients and intervention: Sixty-nine patients with two-part surgical neck fracture of the humerus underwent either an IM nail (38 patients Group A) or a locked plate fixation (31 patients Group B).

Outcomes Measurement: Pain on a visual analog scale (VAS), University of California Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM)

Results: At the two-year follow-up, there were no significant differences in the VAS pain score (1.3 in Group A; 0.9 in Group B), ASES score (90.2 in Group A; 91.9 in Group B), and UCLA shoulder score (30.7 in Group A; 31.8 in Group B) between groups. Active ROM did not differ significantly between groups. There were three complications in the IM nail group, one nonunion requiring autogenous iliac crest bone graft and two cases of screw loosening.

Conclusion: For displaced surgical neck fractures of the humerus, both IM nailing and locked plate fixation in patients yielded satisfactory outcomes at the two-year follow-up with no significant differences in pain or ROM between groups.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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