Treatment of humeral shaft fractures with antegrade intramedullary locking nail |
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Authors: | Stefanos Tsourvakas Christos Alexandropoulos Ioannis Papachristos Grigorios Tsakoumis Nikolaos Ameridis |
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Institution: | (1) Orthopaedic Department, General Hospital of Trikala, 9, Dorotheou str, 42100 Trikala, Greece |
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Abstract: | Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on
this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical
outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures.
Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department.
Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight
patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and
the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score,
respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses.
There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one
fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five
further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and
one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization
of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications
can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results
is the rule. |
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