Bogdan Obada1, Manar Zekra2, Dan-Marcel Iliescu3, Ion-Andrei Popescu4, Dan-Ovidiu Costea5, Lucian Cristian Petcu6, Madalina Gabriela Iliescu7. 1. Orthopaedic Traumatology Department, Emergency Clinical County Hospital, Constanta, Romania. bogdanobada@yahoo.com. 2. Orthopaedic Traumatology Department, Emergency Clinical County Hospital, Constanta, Romania. 3. Department of Anatomy, Faculty of Medicine, "Ovidius" University of Constanta, Constanta, Romania. 4. Romanian Shoulder Institute, Ortopedicum - Orthopaedic Surgery & Sports Clinic, Bucharest, Romania. 5. General Surgery Department, Emergency Clinical County Hospital, Constanta, Romania. 6. Faculty of Medicine, "Ovidius" University of Constanta, Constanta, Romania. 7. Balneal and Rehabilitation Sanatorium, Techirghiol, Romania.
Abstract
PURPOSE: The aim of the study was to evaluate the antegrade intramedullary locking nail osteosynthesis for the treatment of the proximal and middle thirds of humeral shaft fractures. METHODS: A retrospective study was made on 218 patients diagnosed with humeral diaphysis fractures who undergo surgery with antegrade intramedullary locking nail between January 2017 and December 2021. The clinical follow-up started two days after surgery and continued at one month, three months, six months and one year. The functional recovery evaluation was performed using visual analogue scale (VAS) score, Rating Scale of American Shoulder and Elbow Surgeons Form (ASES), Mayo Elbow Performance Score System (MEPS) and rate of complications. RESULTS: Low intra-operative blood loss, short operation time, short hospitalisation, early mobilisation of the patient and high union rate imposed intramedullary nailing as a standard procedure for the treatment of proximal and middle thirds of humeral diaphyseal fractures in the past years, and the union rate was 99.5%. VAS score evaluated at one month, three months and six months indicated a very good overall post-operative experience. The ASES and MEPS score were evaluated at six months and one year and showed excellent results. All the patients (except 1 case) were able to return to their previous jobs within six months. CONCLUSION: Humeral nailing is associated with early return to function of the upper limb, with very good clinical and functional outcomes of the shoulder and elbow. This method could be considered the best surgical option for the management of proximal middle humeral fractures.
PURPOSE: The aim of the study was to evaluate the antegrade intramedullary locking nail osteosynthesis for the treatment of the proximal and middle thirds of humeral shaft fractures. METHODS: A retrospective study was made on 218 patients diagnosed with humeral diaphysis fractures who undergo surgery with antegrade intramedullary locking nail between January 2017 and December 2021. The clinical follow-up started two days after surgery and continued at one month, three months, six months and one year. The functional recovery evaluation was performed using visual analogue scale (VAS) score, Rating Scale of American Shoulder and Elbow Surgeons Form (ASES), Mayo Elbow Performance Score System (MEPS) and rate of complications. RESULTS: Low intra-operative blood loss, short operation time, short hospitalisation, early mobilisation of the patient and high union rate imposed intramedullary nailing as a standard procedure for the treatment of proximal and middle thirds of humeral diaphyseal fractures in the past years, and the union rate was 99.5%. VAS score evaluated at one month, three months and six months indicated a very good overall post-operative experience. The ASES and MEPS score were evaluated at six months and one year and showed excellent results. All the patients (except 1 case) were able to return to their previous jobs within six months. CONCLUSION: Humeral nailing is associated with early return to function of the upper limb, with very good clinical and functional outcomes of the shoulder and elbow. This method could be considered the best surgical option for the management of proximal middle humeral fractures.
Authors: Michele Bisaccia; Luigi Meccariello; Giuseppe Rinonapoli; Giuseppe Rollo; Marco Pellegrino; Andrea Schiavone; Cristina Ibáñez Vicente; Pellegrino Ferrara; Marco Filipponi; Auro Caraffa Journal: Med Arch Date: 2017-04