Outcome Assessment of Operative Treatment of Humeral Shaft Fractures by Antegrade Unreamed Humeral Nailing (UHN)

Ebrahimpour, Adel; Najafi, Arvin; Raci, Alireza Manafi

doi:10.1007/s12262-012-0756-5

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…Median Coleman score was 56 (range 22–91), indicating a fair overall quality of included studies. 12 studies were ranked poor [ 9 – 11 , 21 , 34 – 39 , 47 , 49 ], 24 studies were ranked fair [ 8 , 12 , 14 – 18 , 20 , 22 – 27 , 30 – 33 , 40 , 41 , 43 , 45 , 46 , 48 ], 3 studies were ranked good [ 13 , 42 , 44 ] and 1 study was ranked excellent [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were four randomized controlled trials (RCTs) [ 13 , 19 , 41 , 42 ], six prospective studies [ 8 , 12 , 43 – 46 ] and 30 retrospective studies [ 9 – 11 , 14 – 18 , 20 – 27 , 30 – 40 , 47 – 49 ]. One study was written in German [ 49 ], and the remaining studies were written in English.…”

Section: Resultsmentioning

confidence: 99%

“…22 studies reported on primary RNP [ 9 – 12 , 14 , 16 , 18 , 20 , 22 , 23 , 26 , 33 – 35 , 37 – 40 , 43 , 45 , 47 , 49 ]. These studies consisted of 922 patients of which 88 presented with primary RNP (10%) (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Hendrickx

Hilgersom

Alkaduhimi

et al. 2020

Arch Orthop Trauma Surg

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Background and purpose Humeral shaft fractures are often associated with radial nerve palsy (RNP) (8-16%). The primary aim of this systematic review was to assess the incidence of primary and secondary RNP in closed humeral shaft fractures. The secondary aim was to compare the recovery rate of primary RNP and the incidence of secondary RNP between operative and non-operative treatment. Methods A systematic literature search was performed in 'Trip Database', 'Embase' and 'PubMed' to identify original studies reporting on RNP in closed humeral shaft fractures. The Coleman Methodology Score was used to grade the quality of the studies. The incidence and recovery of RNP, fracture characteristics and treatment characteristics were extracted. Chi-square and Fisher exact tests were used to compare operative versus non-operative treatment. Results Forty studies reporting on 1758 patients with closed humeral shaft fractures were included. The incidence of primary RNP was 10%. There was no difference in the recovery rate of primary RNP when comparing operative treatment with radial nerve exploration (98%) versus non-operative treatment (91%) (p = 0.29). The incidence of secondary RNP after operative and non-operative treatment was 4% and 0.4%, respectively (p < 0.01). Interpretation One-in-ten patients with a closed humeral shaft fracture has an associated primary RNP, of which > 90% recovers without the need of (re-)intervention. No beneficial effect of early exploration on the recovery of primary RNP could be demonstrated when comparing patients managed non-operatively with those explored early. Patients managed operatively for closed humeral shaft fractures have a higher risk of developing secondary RNP. Level of evidence Level IV; Systematic Review.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Hendrickx

Hilgersom

Alkaduhimi

et al. 2020

Arch Orthop Trauma Surg

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Section: Discussionmentioning

confidence: 99%

“…We believe that the partial loss of anterior flexion resulted from adhesion of the scar tissue in the surgical area and the absence of postoperative functional exercise in some patients. 21,22 Hessmann et al 15 performed a prospective multicenter study on the treatment of PHF with MultiLoc V R nails in 17 patients. At 6 months postoperatively, the mean CMS was 66.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of using MultiLoc® nails to treat four-part proximal humeral fractures

Jia¹,

Li²,

Lin³

et al. 2020

J Int Med Res

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Objective This study was performed to evaluate the clinical effect of MultiLoc® nails (DePuy Synthes, Raynham, MA, USA) on the treatment of four-part proximal humeral fractures (PHFs). Methods From January 2014 to January 2018, 32 patients with four-part PHFs were treated with intramedullary MultiLoc® nails in our hospital. The operation time, bleeding volume, postoperative X-ray findings, and fracture healing status were recorded and analyzed. At the end of follow-up, the clinical outcome was evaluated based on the visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant–Murley score (CMS), and occurrence of any complications. Results Among all patients, the average operation time was 124.5 minutes (range, 91–152 minutes), the average amount of bleeding was 90 mL (range, 55–150 mL), and the fracture healing rate was 100%. At the end of follow-up, the mean VAS score was 1.6 ± 0.4, mean ASES score was 84.4 ± 6.3, and mean CMS was 70.3 ± 6.1; no serious complications had occurred; and the patients exhibited good recovery of shoulder function. Conclusions MultiLoc nails® can be applied to the treatment of four-part PHFs. This surgical fixation method has no obvious complications and helps to restore shoulder function.

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Humeral shaft fracture: systematic review of non-operative and operative treatment

Bergen

Mahabier

Lieshout

et al. 2023

Arch Orthop Trauma Surg

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Introduction Humeral shaft fractures can be treated non-operatively or operatively. The optimal management is subject to debate. The aim was to compare non-operative and operative treatment of a humeral shaft fracture in terms of fracture healing, complications, and functional outcome. Methods Databases of Embase, Medline ALL, Web-of-Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were systematically searched for publications reporting clinical and functional outcomes of humeral shaft fractures after non-operative treatment with a functional brace or operative treatment by intramedullary nailing (IMN; antegrade or retrograde) or plate osteosynthesis (open plating or minimally invasive). A pooled analysis of the results was performed using MedCalc. Results A total of 173 studies, describing 11,868 patients, were included. The fracture healing rate for the non-operative group was 89% (95% confidence interval (CI) 84–92%), 94% (95% CI 92–95%) for the IMN group and 96% (95% CI 95–97%) for the plating group. The rate of secondary radial nerve palsies was 1% in patients treated non-operatively, 3% in the IMN, and 6% in the plating group. Intraoperative complications and implant failures occurred more frequently in the IMN group than in the plating group. The DASH score was the lowest (7/100; 95% CI 1–13) in the minimally invasive plate osteosynthesis group. The Constant–Murley and UCLA shoulder score were the highest [93/100 (95% CI 92–95) and 33/35 (95% CI 32–33), respectively] in the plating group. Conclusion This study suggests that even though all treatment modalities result in satisfactory outcomes, operative treatment is associated with the most favorable results. Disregarding secondary radial nerve palsy, specifically plate osteosynthesis seems to result in the highest fracture healing rates, least complications, and best functional outcomes compared with the other treatment modalities.

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Outcome Assessment of Operative Treatment of Humeral Shaft Fractures by Antegrade Unreamed Humeral Nailing (UHN)

Cited by 4 publications

References 14 publications

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Radial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients

Clinical effect of using MultiLoc® nails to treat four-part proximal humeral fractures

Humeral shaft fracture: systematic review of non-operative and operative treatment

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