Abstract

Background: The choice of surgical management significantly influences the functional recovery of the shoulder. Locking plate fixation and primary hemiarthroplasty are two widely practiced modalities for managing complex proximal humerus fractures, particularly Neer’s 3 and 4 part types. Objective: To evaluate and compare the functional outcomes of proximal humerus fractures treated with proximal humerus locking plate fixation versus primary hemiarthroplasty. Methods: This prospective comparative study was conducted at Dr. PDMMC, Amravati. Among a total of 50 patients with displaced 3 or 4 part proximal humerus fractures were enrolled and divided into two groups: Group A (n=25) treated with proximal humerus locking plate, and Group B (n=25) treated with primary hemiarthroplasty. Patients were followed up at regular intervals, and functional outcomes were assessed using the Modified UCLA Shoulder Score and shoulder range of motion measurements. Results: Both treatment modalities led to satisfactory outcomes; however, the locking plate group demonstrated superior results in terms of range of motion, patient satisfaction, and overall functional scores. The hemiarthroplasty group showed more consistent results in elderly patients with complex fracture pattern and lower functional demands with osteopenic bones. Conclusion: Locking plate fixation provides better functional outcomes and range of motion compared to hemiarthroplasty in selected patients with proximal humerus fractures, especially in younger individuals with good bone quality.

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