title: The Telegraph nail for proximal humeral fractures: a prospective four-year study.
abstract: Proximal humeral fractures in 67 patients older than 50 years treated with the Telegraph nail (FH Orthopedics, Heimsbrunn, France) were monitored for 4 years to assess the fracture pattern (weighted Constant score), ranges of motion, and patient satisfaction. The outcome was best in patients with extraarticular surgical neck fractures (mean weighted Constant score, 93.5%); scores were 85% and 77.5%, respectively, for valgus impacted fractures and intraarticular displaced or dislocated fractures. Some or all of the hardware was removed in 21 patients (31%). Two required implant removed for mechanical problems related to screw positioning or migration; 8 were revised because proximal migration of the implant resulted in subacromial impingement. Avascular necrosis occurred in 18% of valgus impacted fractures and in 37.5% of displaced articular or dislocated fractures. Secondary migration of the tuberosities occurred in 6 (all 4-part fractures). The Telegraph nail provides a reproducible and satisfactory outcome for surgical neck and valgus impacted fractures in older patients. The outcome was less satisfactory for unstable articular or dislocated fractures.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Régional Metz-Hôpital Bon-Secours, Metz, France. c.cuny@chr-metz-thionville.fr
authors.forename: Christian
authors.initials: C
authors.lastname: Cuny
authors.forename: Marius M
authors.initials: MM
authors.lastname: Scarlat
authors.forename: M'barek
authors.initials: M
authors.lastname: Irrazi
authors.forename: Patrick
authors.initials: P
authors.lastname: Beau
authors.forename: Valerie
authors.initials: V
authors.lastname: Wenger
authors.forename: Nicolae
authors.initials: N
authors.lastname: Ionescu
authors.forename: Aboubekr
authors.initials: A
authors.lastname: Berrichi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012784:Shoulder Fractures / Q000145:classification / Q000601:surgery*