Retrograde intramedullary nailing in humeral fractures with new implants. Analyse of 120 consecutive cases

Loitz, D.; Könnecker, H.; Illgner, A.; Reilmann, H.

doi:10.1007/s001130050307

Cited by 24 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings are in agreement with those of several other authors [12, 13]. According to their mechanisms, the accidents can be divided into high-energy and low-energy trauma.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Primary Exploration of Radial Nerve is Not Required for Radial Nerve Palsy while Treating Humerus Shaft Fractures with Unreamed Humerus Nails (UHN)

Grass

Kabir²,

Ohse³

et al. 2011

TOORTHJ

View full text Add to dashboard Cite

Background:Today, humerus nails have become the surgical method of choice in the treatment of humerus shaft fractures. Whether or not the radial nerve should be intraoperatively examined by default in case of primary paresis is currently under discussion.Patients and Methods:Clinical findings from 38 patients with humeral shaft fractures surgically treated with unreamed humerus nail (UHN) at the Department of Accident Surgery, University Clinics Bonn, Germany, between 2000 and 2003 were retrospectively assessed. Constant Score was applied for evaluation of functional results.Results:In 40% of patients, primary radial nerve paresis was present. This was especially common after high energy trauma (e.g. traffic accident) and significantly increased in fractures of the middle third. In 93% of cases, spontaneous remission of motor and sensory loss was observed. No iatrogenic radial nerve impairment occurred.Conclusion:Due to the high rates of spontaneous remissions of radial nerve palsy after treatment with UHN in humerus shaft fractures, primar exploration of the radial nerve does not appear to be necessary.

show abstract

“…These findings are in agreement with those of several other authors [12, 13]. According to their mechanisms, the accidents can be divided into high-energy and low-energy trauma.…”

Section: Discussionsupporting

confidence: 93%

“…Loitz and co-authors [12] found in their study on retrograde medullary nailing a value of 87 % for the unaffected side. In this patient cohort, the only gender-specific difference was the fact that female patients had on average a marginally better value by 2% on both sides.…”

Section: Discussionmentioning

confidence: 99%

Primary Exploration of Radial Nerve is Not Required for Radial Nerve Palsy while Treating Humerus Shaft Fractures with Unreamed Humerus Nails (UHN)

Grass

Kabir²,

Ohse³

et al. 2011

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…Shoulder function was significantly worse after antegrade nailing [114]. With retrograde nailing, peri-articular ossification and adhesions in the elbow region disturbing elbow function, also have been described [21,35,38,84,105,113,115]. According to Faragos no sufficient arguments exist in favour of either way of introduction [41].…”

Section: Insertion Site Morbiditymentioning

confidence: 99%

The Locking Nail for the Humerus - Does it Fulfill the Expectations?

Verbruggen¹

2008

Osteosynthesis and Trauma Care

View full text Add to dashboard Cite

IntroductionThe humeral shaft fracture constitutes only 1 to 5 % of all human fractures [57,68,82]. Most of the time it concerns simple fracture patterns, type A or B according to the AO classification. In less then 18 % C-type fractures are found. Less then 6 % are open fractures [28,82,89,128]. In the above 50s, 80 % of humeral shaft fractures are caused by a simple fall [7]. Combined with the lower anatomical demands for the humerus, this makes it the ideal bone for non-operative treatment (Fig. 1). The Sarmiento brace allows early use of shoulder and elbow joint and can be considered the standard for treatment of humeral shaft fractures [37,61,67,71,77,92,110,112,137,138,142]. Despite good results, high failure rates up to 41 % have been reported after non-operative treatment as well [27,48]. Some circumstances therefore will request operative treatment of humeral shaft fractures. These include failure to maintain reposition, neurovascular lesion, floating elbow, (impending) pathologic fractures, open fractures, poly-trauma, non-union and uncooperative patients. The golden standard for operative treatment of the humerus has been the plate (Fig. 2) for a long time leading to high union rates [4, 8, 9,32,33,58,59,60,87,91,130,141] ( Table 1). The most important point of criticism has been the large incisions with soft tissue damage enhancing the risk for non-union and infection. For a long time the only alternative technique for the plate were the elastic nails like bundle nailing and rush pins. Minimal invasive techniques, indirect reposition of the fracture preserving the fracture haematoma and less soft tissue damage are the main advantages. Good healing results have been reported with non-union rates of 1.2 up till 6.8 % [21, 25, 27,34,35,38,47]. Disadvantages are the lesser rotational and axial stability of the constructs. Early functional treatment therefore is not always possible.An interlocking nail combines the minimal invasive technique with the rotational and axial stability of a plate. Seidel introduced the Humeral Locking Nail ® (SN) (Fig. 3). Good healing results with non-union rates of 0 up to 4 %. have been reported. AbstractThe purpose of this article is to evaluate the humeral locking nail in the treatment of humeral shaft fractures. First disappointing experiences with reamed locking nails led at least to some controversy. A review of the literature on treatment of humeral fractures showed that he majority of (clinical) information was contained in retrospective reviews; only three prospective or randomized studies were identified. Furthermore the results are not consistent. The criticism based on experiences with first implants is not entirely justified. The humeral locking nail is a valid implant for the treatment of humeral fractures. Like every other implant however it comes with its own specific complications and there is a learning curve. The humeral locking nail therefore should be seen as a complementary technique to the existing implants with its own advantages and drawbacks.

show abstract

“…Die Drahtwanderung wird von Hofmann et al [30] mit 21 % angegeben und ein sekundärer Repositionsverlust in 16 % der Fälle beobachtet. Retrograd eingebrachte Humerusnägel mit ausfahrbaren Krallen als Fixierung der proximalen Fraktur wiesen vergleichbare Implantatperforationen und sekundäre Fehlstellungen, wie die intramedulläre Zifko-Nagelung [54], insbesondere im osteoporotischen Knochen, auf. Retrograd eingebrachte Humerusnägel mit ausfahrbaren Krallen als Fixierung der proximalen Fraktur wiesen vergleichbare Implantatperforationen und sekundäre Fehlstellungen, wie die intramedulläre Zifko-Nagelung [54], insbesondere im osteoporotischen Knochen, auf.…”

Section: Subkapitale 2-segmentfrakturenunclassified

Konservative oder operative Versorgung der Humeruskopffraktur beim alten Menschen?

Lill

Josten

2001

Chirurg

View full text Add to dashboard Cite

The humeral head fracture in the elderly represents an unresolved problem, which is reflected by the variety of existing therapeutic strategies ranging from conservative treatment to humeral head replacement. The main factors influencing the prognostic outcome are the fracture type, age of the patient and biologic criteria such as osteoporosis, blood supply at the fragments, and the degree of soft tissue trauma. For selection of the optimal treatment, the general condition of the patient, additional injuries and chronic diseases have to be respected as much as the patient's compliance and personal demands. According to experimental and clinical findings, for displaced two- and three-part fractures of the elderly patient minimal osteosynthesis and in the future plate osteosynthesis with angular stability should be preferred. For these fracture types, conservative treatment must be included in the therapeutic spectrum. In contrast, displaced four-part fractures and fracture dislocations are indications for primary humeral head replacement. This is explained by the fact that neither conservative treatment nor surgical reconstruction procedures meet the main goal of primary therapy, aiming for early painless mobilization and for timely discharging the elderly patients in their social environment.

show abstract

Retrograde intramedullary nailing in humeral fractures with new implants. Analyse of 120 consecutive cases

Cited by 24 publications

References 0 publications

Primary Exploration of Radial Nerve is Not Required for Radial Nerve Palsy while Treating Humerus Shaft Fractures with Unreamed Humerus Nails (UHN)

Primary Exploration of Radial Nerve is Not Required for Radial Nerve Palsy while Treating Humerus Shaft Fractures with Unreamed Humerus Nails (UHN)

The Locking Nail for the Humerus - Does it Fulfill the Expectations?

Konservative oder operative Versorgung der Humeruskopffraktur beim alten Menschen?

Contact Info

Product

Resources

About