[The long Telegraph nail for humeral fractures].
OBJECTIVE
We present an anterograde nailing system for humeral shaft fractures: the long Telegraph(R) nail. This nail enables static or dynamic anteroposterior distal locking and is easy to insert with the special aiming device.


METHODS
This study concerned 148 patients who underwent surgery between September 1998 and February 2005, 86 women, men age 68 years and 62 men, mean age 53 years. After excluding patients lost to follow-up and pathological fractures, we analyzed 104 files to determine the rate of nonunion as a function of distal locking or not and dynamic versus static locking. We also reviewed 56 patients measuring the Constant score at mean 2.7 years follow-up.


RESULTS
There were no cases of iatrogenic radial palsy and no cases of infection. There were four cases of nail fracture. The overall rate of nonunion was 7.7%. Nonunion was never observed with dynamic distal locking (p=0.03). Regarding the effect of the nail on shoulder function, the mean weighted Constant score was 105.4% with preservation of mean joint motion and a pain free shoulder in 36/56 patients.


CONCLUSIONS
The long Telegraph(R) nail enables anterograde nailing of the humeral shaft with a simplified system for dynamic or static distal locking. In this series, dynamic distal locking appeared to provide the best rate of nonunion. If installed correctly, the system does not appear to affect shoulder function.
Service de Chirurgie Orthopédique et Traumatologique, CHR de Metz, hôpital Bon-Secours, 1, place de Vigneulles, 57038 Metz Cedex. c.cuny@chr-metz-thionville.fr
C
C
Cuny
M
M
Irrazi
N
N
Ionescu
V
V
Locquet
P-L
PL
Chaumont
A
A
Berrichi
V
V
Wenger
D000368:Aged; D001858:Bone Nails / Q000009:adverse effects; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011542:Pseudarthrosis / Q000209:etiology; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000209:etiology