{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:11:25Z","timestamp":1787695885150,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Proximal humerus fractures account for approximately 5% of all skeletal injuries, and their optimal surgical management remains debated. The optimal fixation method for three-part proximal humerus fractures remains a matter of debate. This study aimed to compare the clinical and radiological outcomes of two minimally invasive osteosynthesis techniques\u2014plate fixation and intramedullary nailing\u2014for the treatment of three-part proximal humerus fractures. Methods: Sixty-six patients aged 60\u201380 years were retrospectively analyzed across two centers adopting different institutional preferences. Thirty-three patients were treated with minimally invasive plate fixation and thirty-three with intramedullary nailing. The mean age was 67.8 \u00b1 4.2 years, and the mean follow-up duration was 27.2 months. Functional and clinical outcomes were evaluated using the Barthel Index, DASH, Simple Shoulder Test (SST), and Visual Analog Scale (VAS). Operative time, hospitalization length, healing time, and postoperative complications were recorded and statistically analyzed. Results: Intramedullary nailing was associated with shorter operative and hospitalization times and fewer complications. Early SST and VAS improvements favored the nailing group, while long-term outcomes were comparable. Conclusions: Intramedullary nailing represents a reliable and less invasive alternative to plate fixation in the treatment of three-part proximal humerus fractures. It offers shorter operative and hospitalization times, fewer postoperative complications, and faster functional recovery while achieving comparable long-term outcomes. Surgeon experience and familiarity with the chosen technique remain key determinants of success.<\/jats:p>","DOI":"10.3390\/jcm14217880","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T11:41:47Z","timestamp":1762515707000},"page":"7880","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Minimally Invasive Treatment of Three-Part Proximal Humerus Fractures: A Two-Center Comparative Study of Plate Fixation and Intramedullary Nailing"],"prefix":"10.3390","volume":"14","author":[{"given":"Calogero","family":"Puma Pagliarello","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Via Taverna 49, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-8066","authenticated-orcid":false,"given":"Vito","family":"Pavone","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical-Surgical Specialties, A.O.U. Policlinico Rodolico-San Marco, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3180-4234","authenticated-orcid":false,"given":"Fabrizio","family":"Quattrini","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Via Taverna 49, 29121 Piacenza, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Maniscalco","sequence":"additional","affiliation":[{"name":"Department of Medicine and Aging Sciences, University of Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Masoni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University of Turin, Via Zuretti, 29, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7094-4344","authenticated-orcid":false,"given":"Corrado","family":"Ciatti","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Via Taverna 49, 29121 Piacenza, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Biberthaler, P., and Wijdicks, J.P. 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