Treatment of two-part fractures of the surgical neck of the humerus using a locked metaphyseal intramedullary nail proximally with angular stability

Abstract

ObjectivesTo evaluate the functional results from patients with surgical neck fractures treated with a locked metaphyseal intramedullary nail and angular stability.MethodsTwenty-two patients between the ages of 21 and 69 years were evaluated prospectively between January 2010 and January 2011. Their time taken for consolidation, age, sex, complications and functional results were correlated using the modified protocol of the University of California at Los Angeles (UCLA).ResultsThe mean time taken for consolidation was 9.26 weeks ± confidence interval (CI) of 0.40 weeks. One case (4.5%) did not become consolidated. There were no cases of infection. There was one case (4.5%) of adhesive capsulitis with good evolution through clinical treatment. Five patients (22.7%) presented occasional mild pain and one case (4.5%) reported medium-intensity pain associated with the subacromial impact of the implant. The mean score on the modified UCLA scale was 30.4 ± CI 1.6 points, obtained at the end of 12 weeks of evaluation: 18 cases (81.8%) with “excellent” and “good” scores, three cases (13.6%) with “fair” scores and one case (4.5%) with a “poor” score.ConclusionIn the group of patients evaluated, treatment of two-part surgical neck fractures by means of a locked metaphyseal intramedullary nail and angular stability demonstrated satisfactory functional results and a low complication rate, similar to what is seen in the literature.

Ultrasound evaluation of the rotator cuff after osteosynthesis of proximal humeral fractures with locking intramedullary nail

“…Clinical results are similar among patients undergoing osteosynthesis with locking plates or nails. 6 , 7 , 12 , 13 , 14 , 15 However, there is disagreement as to which one generates a higher rate of complications. 6 , 14 , 16 The risk of rupture or changes in the rotator cuff after intramedullary nails has been scarcely studied, 7 , 13 , 17 , 18 and no article mentions a standardized and detailed evaluation of the rotator cuff.…”