Complications of Marchetti locked nailing for humeral shaft fractures

Abstract

In this retrospective study 50 humeral fractures (36 acute, 6 pathological fractures and 8 nonunions) were treated by retrograde locked bundled Marchetti nailing. No intraoperative complications occurred. Postoperative complications included 7 nonunions (4/36 acute fractures and 3/8 delayed union), and 2 intraarticular penetrations of the secondary nails. However, at the subsequent removal of the implant 5 supracondylar fractures occurred.

Functional long-term outcome of the shoulder after antegrade intramedullary nailing in humeral diaphyseal fractures

“…Rommens et al [13] reviewed 190 retrograde humeral nailings performed with UHN nails, and reported 8 (4.2%) iatrogenic fractures of the distal humerus at the entry point; Simon et al [34] reviewed 50 humeral fractures treated with Marchetti-Vicenzi nailing and observed 2 (4%) compound fractures of the distal humerus during insertion and 5 (10%) supracondylar fractures of the humerus during removal. Blum et al [31] reviewed 57 patients treated with retrograde fixation using UHN nails, and reported 3 (5.2%) iatrogenic fractures of the distal humerus at the entry point and one humeral shaft fracture during nail insertion.…”

“…Retrograde nailing, which is fully extra-articular, has obtained excellent results in terms of elbow and shoulder function, however it does imply some disadvantages [13,[31][32][33][34]. Rommens et al [13] reviewed 190 retrograde humeral nailings performed with UHN nails, and reported 8 (4.2%) iatrogenic fractures of the distal humerus at the entry point; Simon et al [34] reviewed 50 humeral fractures treated with Marchetti-Vicenzi nailing and observed 2 (4%) compound fractures of the distal humerus during insertion and 5 (10%) supracondylar fractures of the humerus during removal.…”

Treatment of Pathological Fractures of the Humerus with a Locked Intramedullary Nail

“…Even in the situation of a non-rigid humeral nail, the retrograde approach has been reported to be associated with a higher-thanusual iatrogenic fracture rate, even in normal bone. 12 For this reason, we do not recommend the retrograde approach for insertion of rigid humeral nails.…”

Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails

“…However, earlier reports on intramedullary flexible nailing have shown the problems of inadequate rotational stability. Although interlocking intramedullary nailing provides antirotation and load-sharing capabilities; the common complications of the closed technique include increased fracture comminution and injury of the rotator cuff, which subsequently limits shoulder motion [13,19]. Consequently, we conducted this retrospective study to compare the clinical results and efficacy of dynamic compression plate (DCP), flexible intramedullary ender nails (EN) and interlocking intramedullary nail (ILN) for the treatment of acute, closed, and displaced humeral shaft fractures.…”