M A Cox1, M Dolan, K Synnott, J P McElwain. 1. Department of Orthopaedic Surgery, The Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
Abstract
OBJECTIVE: To assess the role of the Russell-Taylor humeral nail in the treatment of humeral shaft fractures. STUDY DESIGN: Retrospective with a mean radiologic and clinical follow-up at thirty-two months. SETTING: University teaching hospital. PATIENTS: Total of thirty-seven patients treated with the Russell-Taylor humeral nail. INTERVENTION: All patients were treated with the Russell-Taylor humeral nail inserted in an antegrade fashion. OUTCOME MEASURES: Radiologic union and shoulder function in terms of pain, power, range of movement, and activities of daily living. RESULTS: There were four established nonunions and four cases of delayed union (time to union > four months). Age of patient was the only predictor of nonunion. There was one infection and one intraoperative fracture. Two prominent proximal screws required removal, and one nail was removed after union because of impingement. Three patients required manipulation under anesthesia to improve shoulder movement. At review, six patients had residual poor shoulder function as per Constant score, four attributable to shoulder stiffness and two to residual pain. CONCLUSION: The authors' findings indicate a significant rate of delayed or nonunion in the elderly patient. When the high rate of union with conservative treatment is considered, the indications and rationale for intramedullary humeral nailing should be clearly defined.
OBJECTIVE: To assess the role of the Russell-Taylor humeral nail in the treatment of humeral shaft fractures. STUDY DESIGN: Retrospective with a mean radiologic and clinical follow-up at thirty-two months. SETTING: University teaching hospital. PATIENTS: Total of thirty-seven patients treated with the Russell-Taylor humeral nail. INTERVENTION: All patients were treated with the Russell-Taylor humeral nail inserted in an antegrade fashion. OUTCOME MEASURES: Radiologic union and shoulder function in terms of pain, power, range of movement, and activities of daily living. RESULTS: There were four established nonunions and four cases of delayed union (time to union > four months). Age of patient was the only predictor of nonunion. There was one infection and one intraoperative fracture. Two prominent proximal screws required removal, and one nail was removed after union because of impingement. Three patients required manipulation under anesthesia to improve shoulder movement. At review, six patients had residual poor shoulder function as per Constant score, four attributable to shoulder stiffness and two to residual pain. CONCLUSION: The authors' findings indicate a significant rate of delayed or nonunion in the elderly patient. When the high rate of union with conservative treatment is considered, the indications and rationale for intramedullary humeral nailing should be clearly defined.
Authors: Robert Zura; Samir Mehta; Gregory J Della Rocca; John Jones; R Grant Steen Journal: BMC Musculoskelet Disord Date: 2015-03-01 Impact factor: 2.362
Authors: Mário Chaves Corrêa; Felipe Antônio Gomes; Daniel Campos Linhares; Lucas Braga Jacques Gonçalves; José Carlos Souza Vilela; Ronaldo Percopi de Andrade Journal: Rev Bras Ortop Date: 2015-11-17