S Congia1, A Palmas2, G Marongiu2, A Capone2. 1. Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy. stefano.congia@tiscali.it. 2. Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, 09100, Cagliari, Sardegna, Italy.
Abstract
PURPOSE: To report our experience with antegrade short locked intramedullary nail for treatment of proximal humeral fractures and to review the current literature. MATERIALS AND METHODS: From January 2012 to July 2013, 41 patients affected by two and three-part proximal humeral fractures were treated with surgical internal fixation with short locked intramedullary nails. Outcome analysis included standard clinical follow-up, Constant shoulder score and plain radiographs. The mean follow-up was 30 months (range 24-42). Moreover, a review of the literature was carried out. RESULTS: The mean Constant shoulder score was 81.5, excellent functional outcomes in 24/38 patients. All the fractures healed in an average time of 3.7 months. Five patients underwent additional operations, complications included hardware penetration into the joint (n = 2), backed out screw (n = 1), shoulder impingement due to protrusion of the nail (n = 2) and superficial infection (n = 1). The literature review showed 530 patients affected by proximal humeral fracture and treated with intramedullary nail with mean age of 65 years, mean follow-up of 22.2 months and a Constant shoulder score of 72.9 points; the major complications reported were backing out of the screws, shoulder impingement and joint protrusion of the screws. CONCLUSIONS: Antegrade short locked intramedullary nail allows stable fixation, minimal soft tissue dissection, early mobilization of the shoulder and good outcomes. It is an efficacious therapeutic solution for 2- and 3-part proximal humeral fractures.
PURPOSE: To report our experience with antegrade short locked intramedullary nail for treatment of proximal humeral fractures and to review the current literature. MATERIALS AND METHODS: From January 2012 to July 2013, 41 patients affected by two and three-part proximal humeral fractures were treated with surgical internal fixation with short locked intramedullary nails. Outcome analysis included standard clinical follow-up, Constant shoulder score and plain radiographs. The mean follow-up was 30 months (range 24-42). Moreover, a review of the literature was carried out. RESULTS: The mean Constant shoulder score was 81.5, excellent functional outcomes in 24/38 patients. All the fractures healed in an average time of 3.7 months. Five patients underwent additional operations, complications included hardware penetration into the joint (n = 2), backed out screw (n = 1), shoulder impingement due to protrusion of the nail (n = 2) and superficial infection (n = 1). The literature review showed 530 patients affected by proximal humeral fracture and treated with intramedullary nail with mean age of 65 years, mean follow-up of 22.2 months and a Constant shoulder score of 72.9 points; the major complications reported were backing out of the screws, shoulder impingement and joint protrusion of the screws. CONCLUSIONS: Antegrade short locked intramedullary nail allows stable fixation, minimal soft tissue dissection, early mobilization of the shoulder and good outcomes. It is an efficacious therapeutic solution for 2- and 3-part proximal humeral fractures.
Authors: Maximilian Willauschus; Linus Schram; Michael Millrose; Johannes Rüther; Kim Loose; Hermann Josef Bail; Markus Geßlein Journal: J Clin Med Date: 2022-04-30 Impact factor: 4.964