Thierry Scheerlinck1, Frank Handelberg. 1. Department of Orthopaedic Surgery and Traumatology, Academic Hospital, Vrise Universiteit, Brussels, Belgium. scheerlinkt@belgacom.net
Abstract
BACKGROUND: We compared anesthesia time, complications, fracture healing, as well as shoulder and elbow function after retrograde and antegrade nailing of humeral shaft fractures or impending fractures. METHODS: Thirty retrograde Marchetti-Vicenzi nails (MVN) and 22 antegrade locked AO unreamed humeral nails (AO-UHN) were inserted in 52 patients. Forty-three fractures were followed up until healing, and three required reoperation for nonunion (two MVN, one AO-UHN). Nineteen MVN and 17 AO-UHN patients were evaluated according to Constant's shoulder score and HSS elbow score after an average of 2 years (0.5-3.4 years). RESULTS: Anesthesia time did not differ significantly in both groups. Differences in Constant's shoulder score between healthy and affected side were more important in the AO-UHN group due to limitation in ROM and loss of abduction power. Differences in HSS elbow score were similar in both groups, although four supracondylar fractures occurred in the MVN group. CONCLUSION: The retrograde approach to the humeral medullary cavity using a MVN resulted in better shoulder function and similar elbow function compared with the antegrade approach using an AO-UHN.
BACKGROUND: We compared anesthesia time, complications, fracture healing, as well as shoulder and elbow function after retrograde and antegrade nailing of humeral shaft fractures or impending fractures. METHODS: Thirty retrograde Marchetti-Vicenzi nails (MVN) and 22 antegrade locked AO unreamed humeral nails (AO-UHN) were inserted in 52 patients. Forty-three fractures were followed up until healing, and three required reoperation for nonunion (two MVN, one AO-UHN). Nineteen MVN and 17 AO-UHN patients were evaluated according to Constant's shoulder score and HSS elbow score after an average of 2 years (0.5-3.4 years). RESULTS: Anesthesia time did not differ significantly in both groups. Differences in Constant's shoulder score between healthy and affected side were more important in the AO-UHN group due to limitation in ROM and loss of abduction power. Differences in HSS elbow score were similar in both groups, although four supracondylar fractures occurred in the MVN group. CONCLUSION: The retrograde approach to the humeral medullary cavity using a MVN resulted in better shoulder function and similar elbow function compared with the antegrade approach using an AO-UHN.
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