Low Revision Rates with Locking Plate Fixation of Proximal Humerus Fractures: A Comparison of Two Implant Systems

The purpose of this study was to compare outcomes following open reduction and internal fixation (ORIF) of proximal humerus fractures with Zimmer Biomet and DePuy Synthes plating systems. This was a retrospective review of patients who underwent proximal humerus fracture fixation utilizing Zimmer Biomet or DePuy Synthes plating systems between June 2016 and February 2023. Patients without postoperative follow-up were excluded. Complication rates were compared between the two cohorts using chi-square and two-tailed t-tests for categorical and continuous variables, respectively. A total of 86 patients were identified for inclusion and eight were excluded for inadequate follow up. Statistical analysis comprised a total of 78 patients, 41 who underwent ORIF with a Zimmer Biomet implant, and 37 who underwent ORIF with a DePuy Synthes implant. The overall complication rate was 4.88% (n = 2) in the Zimmer Biomet cohort and 13.5% (n = 5) in the DePuy Synthes cohort (P > 0.05). Both Zimmer Biomet patients required revision surgery, compared with two out of five patients in the DePuy-Synthes group. There were no statistically significant differences in rates of avascular necrosis, impingement, malunion, or fixation failure between the two cohorts. Overall complication rate and need for revision surgery were similar between patients who underwent fixation with the Zimmer Biomet or DePuy Synthes plating systems. Our findings support selection of either plating system based on surgeon preference and equipment availability as neither demonstrated clinical superiority.