title: Expandable nail system for osteoporotic humeral shaft fractures: preliminary results.
abstract: BACKGROUND
  Conventional nails rely on interlocking screws for axial and rotational stability. Such screws have poor fixation in patients with poor bone quality (osteopenia). The Fixion nail does not depend on interlocking screws-axial and rotational stability is instead achieved by nail expansion. Therefore, this nail may be better suited for patients with poor bone quality who require humeral stabilization.
  
  
  METHODS
  The system was used to manage 25 unstable humerus shaft fractures in osteoporotic bone. An antegrade approach was used in 18 patients and a retrograde approach was used in 7 patients.
  
  
  RESULTS
  There were no intra- or postoperative complications. Postoperatively, all fractures were stable and had healed by week 16. The mean operative time was 35 +/- 10 minutes (+/- SD) including 1.5 +/- 0.5 minutes of fluoroscopy time.
  
  
  CONCLUSIONS
  The results of this study show that use of this nailing system is associated with minimal complications, predictable fracture healing, and excellent functional outcomes in a cohort of elderly patients with poor bone quality and humeral shaft fractures requiring stabilization. Further confirmation by larger prospective trials is necessary.
authors.affiliation: Department of Surgery, Friedrich Alexander University, Erlangen, Germany. wolfgang.franck@chir.imed.uni-erlangen.de
authors.forename: Wolfgang Maria
authors.initials: WM
authors.lastname: Franck
authors.forename: Manuel
authors.initials: M
authors.lastname: Olivieri
authors.forename: Olof
authors.initials: O
authors.lastname: Jannasch
authors.forename: Frank Friedrich
authors.initials: FF
authors.lastname: Hennig
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000534:rehabilitation; D017102:Fracture Healing; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D016684:Prone Position; D011859:Radiography; D016059:Range of Motion, Articular; D016683:Supine Position; D016896:Treatment Outcome