title: Treatment of proximal humeral fractures with a new intramedullary nail.
abstract: We have developed a new intramedullary nail (All-in-One Nail) that is specifically designed for elastic fixation of a surgical neck fracture of the humerus. This nail has three pins and a plate, and the pins become divergent as the nail is inserted into the marrow cavity through the deltoid tuberosity and then advanced to the humeral head. We reviewed 31 patients with an age range of 58-91 years (mean 75 years) who underwent surgery with this nail for A3.2 (two-part), B2.2 (three-part), or C2.1 (valgus-impacted) fractures of the proximal humerus. Bony union was obtained in 29 patients, and these patients had a Japanese Orthopaedic Association shoulder score of 60-92 (mean 78) in a follow-up examination performed 6-32 months (mean 13 months) postoperatively. The All-in-One Nail system is easy to use, provides an acceptable clinical outcome, and is a treatment option for unimpacted surgical neck fractures and valgus-impacted fractures of the humerus.
authors.affiliation: Department of Orthopaedics, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tamai
authors.forename: Wataru
authors.initials: W
authors.lastname: Ohno
authors.forename: Michio
authors.initials: M
authors.lastname: Takemura
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Mashitori
authors.forename: Jun'ichiro
authors.initials: J
authors.lastname: Hamada
authors.forename: Koichi
authors.initials: K
authors.lastname: Saotome
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012784:Shoulder Fractures / Q000601:surgery*