OBJECTIVETo study the effect of the treatment for comminuted fractures of proximal humerus with open reduction and internal fixation, and the influence of the different internal fixation.

METHODSFrom January 2003 to June 2007, 423 cases of comminuted fractures of proximal humerus were treated with open reduction and internal fixation. Among them, 139 patients included 51 males and 88 females were treated with the Kirschner needle with an average age of 55.8 years old ranging from 35 to 72 years, and the average course was 7 days (from 3 to 20 days); 103 patients included 48 males and 55 females were treated with the cloverleaf plate with an average age of 56.7 years old (from 22 to 76 years), and the average course was 8.5 days (from 3 to 23 days); 181 patients included 85 males and 96 females were treated with the locking plate with an average age of 57.1 years old (from 29 to 77 years), and the average course was 7.9 days (from 3 to 21 days). The pain, daily activities, orbit, and the strength of the shoulder were evaluated with the Constant's scale.

RESULTSThe wound of all the cases was primary healing. All patients were followed-up for over 12 months, the sings and symptoms of all the patients were improved very well. There was significant difference between, before and after operation on Constant's scoring. While there was not significant difference among the different internal fixation.

CONCLUSIONOpen reduction and internal fixation is effective for comminuted fractures of proximal humerus. There is no significant difference on therapeutic efficacy in different internal fixation.