[Interlocking intramedullary nailing of humeral shaft fractures in adults].
OBJECTIVE
We evaluated the effectiveness of interlocking intramedullary nailing in the treatment of humeral shaft fractures.


METHODS
Forty-three patients (30 men, 13 women; mean age 42 years; range 20 to 83 years) were treated with interlocking intramedullary nailing for humeral shaft fractures. All fractures but one (type II open) were closed. Three patients had radial nerve, one patient had radial and ulnar nerve dysfunction. As all the nerve lesions were assessed as neuropraxia, no immediate surgical exploration was performed. Intramedullary nailing was performed by closed (18 fractures) and open technique (25 fractures), with (n=22) or without (n=21) reaming. Functional evaluation was made according to the Constant-Murley's shoulder scoring system. The mean follow-up was 16.5 months (range 5 to 40 months).


RESULTS
Radiologically, union was achieved in all patients in a mean of 15.6 weeks. No surgery-associated nerve injuries or infections were encountered. Preoperative nerve dysfunction resolved in all patients in a mean of 12.5 weeks. No signs of rotator cuff impingement or restriction were detected in two patients in whom the nails were placed high in close proximity to the shoulder girdle. Of these, one patient underwent reoperation for the removal of the nail after the fracture union completed. Functional results were excellent in all patients at the end of postoperative three months. No significant correlation was found between the techniques employed and time to union and functional outcome.


CONCLUSIONS
Interlocking intramedullary nailing provides adequate fixation and early mobilization, and results in satisfactory radiographic and functional results in the treatment of humeral shaft fractures.
Arpacioğlu
M Omer
MO
GATA Haydarpaşa Eğitim Hastanesi Ortopedi ve Travmatoloji Kliniği, Istanbul.
Pehlivan
Ozcan
O
Akmaz
Ibrahim
I
Kiral
Ahmet
A
Oğuz
Yücel
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary; D005596:Fractures, Closed / Q000601:surgery; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011826:Radial Nerve / Q000293:injuries; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries