Clinical Performance of a New Medullary Humeral Nail: Antegrade Versus Retrograde Insertion

Blum, Jochen; Janzing, H; Gahr, R. H.; Langendorff, H S; Rommens, Pol Maria

doi:10.1097/00005131-200106000-00007

Cited by 62 publications

(39 citation statements)

References 28 publications

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“…Bis vor wenigen Jahren war die Marknagelung des Humerus auf Schaftfrakturen beschränkt [2,4,5,7,[24][25][26]. Die bis dahin üblichen Insertions-und Stabilisierungstechniken solcher Marknagelsysteme schienen metaphysären oder gar epiphysären Frakturen nicht gerecht zu werden [6,20,27].…”

Section: Vorbemerkungenunclassified

Die winkelstabile Marknagelung bei Frakturen am proximalen Humerus mit dem PHN (Proximaler Humerusnagel)

Blum

Hansen²,

Rommens

2009

Orthop Traumatol

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151 proximal humeral fractures were treated with a proximal humeral nail (PHN). 108 patients could be followed up 1 year postoperatively. Significant complications were perforation of the articular surface through bolts or blades (n = 8), implant-related pain (n = 10), fragment dislocation (n = 2), nonunion (n = 2), humeral head necrosis (n = 3), and superficial infection (n = 1). 1 year after the operation, the Constant-Murley Score showed a median value of 75.3 in the injured shoulder and of 89.9 in the uninjured shoulder. The DASH (Disability of the Arm, Shoulder and Hand) Score was 5.9 preoperatively and 9.3 at 1 year postoperatively. The worst results regarding the Constant-Murley Score as well as the DASH Score were found in C-type fractures.

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Section: Vorbemerkungenunclassified

Die winkelstabile Marknagelung bei Frakturen am proximalen Humerus mit dem PHN (Proximaler Humerusnagel)

Blum

Hansen²,

Rommens

2009

Orthop Traumatol

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“…There is still an ongoing discussion about the approach for humeral nailing [12,19]. Early humeral nails like the original Seidel nail showed large diameters and needed reaming.…”

Section: Humeral Shaft Fractures and Nailing Approachmentioning

confidence: 99%

“…Since modern humeral nail systems led to smaller nail diameters and furthermore follow an unreamed technique, the contrast between antegrade and retrograde approaches is less sharp today. For proximal metaphyseal fractures, the antegrade approach is the appropriate one; in pure diaphyseal fractures, we still prefer the retrograde approach, if possible [2,12,19,26].…”

Section: Humeral Shaft Fractures and Nailing Approachmentioning

confidence: 99%

“…The assembled nail is inserted without force, especially without a hammer. With careful rotatory hand movements, the nail is driven to the fracture gap and beyond after fracture reduction, with good visualization provided by image intensifier [2,19,24,25] (Figures 2a to 2c).…”

Section: Humeral Shaft Fractures and Nailing Approachmentioning

confidence: 99%

“…Clinical and biomechanical discussions about using an antegrade rather than a retrograde approach for these very distal shaft fractures are still ongoing and not perfectly answered yet [19,28]. …”

Section: Humeral Shaft Fractures and Nailing Approachmentioning

confidence: 99%

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Intramedullary Nailing of Humeral Head and Humeral Shaft Fractures

Blum¹,

Engelmann

Küchle

et al. 2007

Eur J Trauma Emerg Surg

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There is an increasing interest in intramedullary nailing for humeral fractures. Starting with diaphyseal fractures, now also proximal metaphyseal fractures of the humerus can be nailed with satisfying results. Basic ideas for humeral nailing are less invasive approaches to the humerus, less soft tissue damage, e.g. lower rates of radial nerve palsy, closed reduction and the biomechanical aspects of a central implant with elastic fixation properties. Nailing of diaphyseal humeral shaft fractures is an equivalent alternative to plating; nailing of proximal metaphyseal humeral fractures is still new and needs more reliable scientific data to clear its advantages compared to other fixation techniques. Nailing of distal metaphyseal humeral fractures is no serious option at the moment. Angular stable interlocking systems show better fixation qualities for proximal fractures or fracture components. Although in very osteoporotic bone cutouts are registered. Static interlocking is advisable. High torsional stability of the fracture fixation has to be achieved, since significant torsional load occurs during the usual movement of the upper limbs. As there is an important learning curve, possible complications of intramedullary nailing have to be kept in mind and avoided by a careful operation technique.

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Intramedullary Nailing of Humeral Shaft Fractures

Franke

Practice of Intramedullary Locked Nails

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Clinical Performance of a New Medullary Humeral Nail: Antegrade Versus Retrograde Insertion

Cited by 62 publications

References 28 publications

Die winkelstabile Marknagelung bei Frakturen am proximalen Humerus mit dem PHN (Proximaler Humerusnagel)

Die winkelstabile Marknagelung bei Frakturen am proximalen Humerus mit dem PHN (Proximaler Humerusnagel)

Intramedullary Nailing of Humeral Head and Humeral Shaft Fractures

Intramedullary Nailing of Humeral Shaft Fractures

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