Seidel intramedullary nailing of humeral diaphyseal fractures: a preliminary report

Forty-two humeral diaphyseal fractures in 41 patients were treated at three centers between April 1988 and November 1989. There were 28 acute fractures; four were open. Average time to union was 8 weeks. There were no infections. Six patients with seven pathologic fractures due to metastatic disease died during the course of this study, but the nail had allowed them to be functional with minimal surgical dissection. Five of six nonunions united with one procedure. There was one residual nonunion in a patient with a wide canal and an arthrodesed shoulder above the nonunion. There were three preoperative radial and two preoperative axillary nerve palsies, and no iatrogenic nerve palsies. In all patients with anterior deltoid incisions, shoulder motion returned reliably, but took as long as 6 months. Four rods were left prominent in the rotator cuff and the patients had symptoms of impingement until rod removal. Six patients had restricted shoulder function, one due to a fracture of the humeral head and five from a lateral deltoid incision. This incision was used in 12 cases. There were no stiff shoulders when using an anterior deltoid incision.