To compare the efficacy of artificial humeral head replacement and intramedullary nail fixation in the treatment of complex proximal humeral fractures.

A total of 70 elderly patients with complex proximal humeral fractures admitted to Wuxi Xishan People′s Hospital from December 2019 to December 2021 were selected and divided into two groups according to the different surgical methods: the control group (35 cases) and the observation group (35 cases). The control group were treated by intramedullary nail fixation, and the observation group were treated by artificial femoral head replacement. The visual analogue scale (VAS) score, postoperative shoulder joint function score (Neer score), shoulder joint function score (Constant-Murley score), efficacy and incidence of adverse reactions were compared between the two groups at three weeks, 12 weeks and 16 weeks after operation. The results were analyzed with independent sample t test, repeated measures analysis of variance and chi-square test.

The VAS scores in three, 12 and 16 weeks in the control group were higher than those in the observation group (F=36.301, P<0.05); the Constant-Murley total score was not significantly different between the two groups (t=1.438, P>0.05). the Neer total score in the observation group was higher than the control group (t=2.069, P<0.05); the total effective rate in the observation group was higher than that in the control group (χ²=4.786, P<0.05).

Intramedullary nailing and humeral head replacement can improve the shoulder function of middle-aged and elderly patients with complex proximal humerus fractures. Total efficiency of humeral head replacement is better than intramedullary nailing.