Antegrade interlocking nailing of humeral shaft fractures

Petsatodes, G.; Karataglis, Dimitrios; Papadopoulos, Pericles; Christoforides, J.; Gigis, Ioannis; Pournaras, J.

doi:10.1007/s00776-004-0780-9

Cited by 48 publications

(37 citation statements)

References 26 publications

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“…This can be due to impingement of proximal nail tip or proximal locking screw due to adhesive capsulitis or due to rotator cuff tears. In most of the studies with antegrade nailing, 80-95% of patients regained their normal shoulder function [8,24,30]. In our study, 80% patients had excellent shoulder function with near normal range of motion of shoulder while 16.6% had moderately good shoulder function.…”

Section: Post-operative Complicationsupporting

confidence: 51%

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Does Closed Intramedullary Interlocking Nailing in Patients With Humeral Shaft Fractures Has Advantages: Evaluation Through a Clinical Study

Murari

Chandra

et al. 2017

Asian J Pharm Clin Res

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Objective: Intramedullary interlocking nail fixation (IINF) for the fracture shaft humerus (FSH) offers good clinical outcome. Evaluating the functional outcome of IINF in FSH and assessing the complications of the technique, time taken for fracture consolidation, and union rates were the objectives.Methods: Adult patients with a clinical diagnosis of diaphyseal fracture of humerus were assessed clinically and radiologically for the functional outcome of IINF in FSH. Functional outcome of shoulder and elbow considered together was graded as excellent, moderate, and poor. Daily assessment was done along with active physiotherapy. All were followed up at monthly intervals for 6-12 months or till the union of fracture. Radiological assessment was done at immediate post-operative period, at months 1, 3, 6, 9, and 12 months.Results: 30 patients (males n=24, 80%) with a mean(±standard deviation) age of 39(±13.31) years were included. Road traffic accident was the frequent cause (n=18, 60%). Indirect injury was the cause in 66.66% patients. Middle 1/3 rd of shaft of humerus was fractured in 53.33% patients. 10 (33.3%) patients each had oblique fracture and transverse fracture, respectively; comminuted fracture was seen in another 26.6% patients. Radial nerve palsy (10%) was the frequent associated injury of the total nine. The overall functional outcome was excellent in 80%, moderate in 16.6%, and poor in 3.3% patients. Postoperatively, nonunion, superficial infection and shoulder stiffness was seen in one patient each. Conclusion:IIFN is an excellent, least invasive surgical option for FHS with early fracture consolidation and better union rates.

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Section: Post-operative Complicationsupporting

confidence: 51%

“…Iatrogenic fracture comminution is frequently encountered issue in these patients; reported to be 0-3 in previous studies [5,8,9,24]. In our study, we encountered three cases of intraoperative fracture comminution but this did not interfere with fracture healing and all these fractures united well within 4 months.…”

Section: Post-operative Complicationsupporting

confidence: 45%

Does Closed Intramedullary Interlocking Nailing in Patients With Humeral Shaft Fractures Has Advantages: Evaluation Through a Clinical Study

Murari

Chandra

et al. 2017

Asian J Pharm Clin Res

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“…Operative intervention is indicated in special circumstances including (1) failure of closed reduction, (2) intra-articular extension of fractures, (3) neurovascular compromises, (4) associated ipsilateral forearm and elbow fractures, (5) segmental fractures, (6) pathological fractures, (7) open fractures, (8) fractures in polytraumatised patients, (9) bilateral humeral shaft fractures, (10) periprosthetic fractures and (11) transverse or short oblique fractures [3]. These fractures can be surgically treated by either using a dynamic compression plate [4,5] or intramedullary nails [5][6][7][8]. Although controversy exists over which is the better technique, most authors believe that open reduction and internal fixation with a dynamic compression plate is a more reliable method.…”

Section: Introductionmentioning

confidence: 99%

Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

Zeng

et al. 2009

International Orthopaedics (SICOT)

123

111

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Results of two methods, conventional open reduction-internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n=17) patients were treated by MIPO and group B (n=16) by conventional plating. The mean operation time in group A was 92.35±57.68 minutes and 103.12±31.08 minutes in group B (P=0.513). Iatrogenic radial nerve palsy in group A was 0% (0/17) and 31.3% in group B (5/16 (P=0.012). The mean fracture union time in group A was 15.29±4.01 weeks (range 8-24 weeks), and 21.25±13.67 weeks (range 10-58 weeks) in group B (P=0.095). The mean UCLA end-result score in group A was 34.76±0.56 points (range 33-35), and 34.38± 1.41 points (range 30-35) in group B (P=0.299). The mean MEPI in group A was 99.41±2.43 points (range 90-100) and 99.69±1.25 points (range 95-100) in group B (P= 0.687). When compared to the conventional plating techniques, MIPO offers advantages in terms of reduced incidence of iatrogenic radial nerve palsies and accelerated fracture union and a similar functional outcome with respect to shoulder and elbow function.

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“…Many recent reports have reported similar shoulder dysfunction rates (rated according to ASES and or Constant-Murley scoring) less than 10% and have recommended medial entry point avoiding the avascular area of the cuff, meticulous surgical dissection, static locking of the nail to prevent backing out and complete embedding of the nail as technical tips to minimize cuff related problems and consequent shoulder dysfunction. 17,22,23 Out of the 20 fractures, 18 united by the end of 6 months with an overall union rate of 90%. This result is comparable to the union rate achieved by Crates (94.5%), Fan (96.7%), Chapman (87%), Tsourvakas, (95.8%), Petsatodes (92.3%).…”

Section: Discussionmentioning

confidence: 99%

“…This result is comparable to the union rate achieved by Crates (94.5%), Fan (96.7%), Chapman (87%), Tsourvakas, (95.8%), Petsatodes (92.3%). 6,13,18,22,23 Reported nonunion rate in recent literature is 0-8%. 17 In our series, 2 patients had non-union.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome of antegrade interlocking intramedullary nailing for humeral shaft fractures

et al. 2017

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INTRODUCTIONThe humeral shaft cylindrical in shape, the expanse between the proximal insertion of the pectoralis major and the distal metaphyseal flare of the humerus, adds resistance to both torsional and bending forces and provides strength. Adequate soft tissue envelope favors good prognosis in healing of uncomplicated fractures.Humeral shaft fractures account for approximately 1-3% of all fractures and 20% of humeral fractures with a bimodal distribution with peaks in young male patients, 21-30 years of age, and a larger peak in older females from 60-80 years of age.1 Most humeral diaphysis fractures are simple patterns of the mid-diaphysis These fractures have potential to cause significant disability in the young which is often temporary and in the old often permanent disability.Plating or intramedullary nailing are the main surgical options available for the definitive primary management of closed humeral shaft fractures and have their respective proponents with no consensus. ABSTRACT Background: Humeral shaft fractures which account for approximately 1-3% of all fractures and 20% of humeral fractures have potential to cause significant disability in the young which is often temporary and in the old often permanent disability. The use of locked intramedullary nailing for the treatment of humeral shaft fractures is gaining popularity because of its biomechanical and biological advantages. Methods: We present a descriptive retrospective review of 20 consecutive patients with acute humeral shaft fractures treated using an antegrade interlocking nail. Fracture union, functional outcome measured with Constant-Murley shoulder score and American shoulder and elbow surgeons (ASES) shoulder score and complications were assessed. Results: Patient age ranged from 20 to 74 years (average, 36 years) and average follow-up was 30.7 months (range, 12-48 months). There were 13 male patients and 7 female patients. Fracture of the middle third was most common accounting to 80% (16/20) of the fractures. Fracture union was achieved in 90% (18/20) of our cases. 2 patients had nonunion for which secondary surgeries were needed. According to Constant-Murley score, shoulder function was excellent in 70% (14/20) and good in 25% (5/20). Average ASES score was 93.3%. None of the patients had radial nerve palsy postoperatively. Conclusions: Gentle progressive reaming, correct entry point, minimal damage to rotator cuff, properly embedding the tip of the nail, good apposition of fracture fragments, static locking will help make antegrade intramedullary nailing, a dependable solution for the treatment of humeral shaft fractures and in achieving successful union with preserved/good shoulder and elbow function.

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Antegrade interlocking nailing of humeral shaft fractures

Cited by 48 publications

References 26 publications

Does Closed Intramedullary Interlocking Nailing in Patients With Humeral Shaft Fractures Has Advantages: Evaluation Through a Clinical Study

Does Closed Intramedullary Interlocking Nailing in Patients With Humeral Shaft Fractures Has Advantages: Evaluation Through a Clinical Study

Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

Functional outcome of antegrade interlocking intramedullary nailing for humeral shaft fractures

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