Closed interlocking nailing of humeral shaft fractures with the Russell-Taylor nail.
OBJECTIVE
To assess the role of the Russell-Taylor humeral nail in the treatment of humeral shaft fractures.


METHODS
Retrospective with a mean radiologic and clinical follow-up at thirty-two months.


METHODS
University teaching hospital.


METHODS
Total of thirty-seven patients treated with the Russell-Taylor humeral nail.


METHODS
All patients were treated with the Russell-Taylor humeral nail inserted in an antegrade fashion.


METHODS
Radiologic union and shoulder function in terms of pain, power, range of movement, and activities of daily living.


RESULTS
There were four established nonunions and four cases of delayed union (time to union > four months). Age of patient was the only predictor of nonunion. There was one infection and one intraoperative fracture. Two prominent proximal screws required removal, and one nail was removed after union because of impingement. Three patients required manipulation under anesthesia to improve shoulder movement. At review, six patients had residual poor shoulder function as per Constant score, four attributable to shoulder stiffness and two to residual pain.


CONCLUSIONS
The authors' findings indicate a significant rate of delayed or nonunion in the elderly patient. When the high rate of union with conservative treatment is considered, the indications and rationale for intramedullary humeral nailing should be clearly defined.
Department of Orthopaedic Surgery, The Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
M A
MA
Cox
M
M
Dolan
K
K
Synnott
J P
JP
McElwain
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors