title: Angular-stable locked intramedullary nailing of two-part surgical neck fractures of the proximal part of the humerus. A multicenter retrospective observational study.
abstract: BACKGROUND
  The ideal fixation technique for the treatment of proximal humeral fractures remains unclear. In the present study, we evaluated the experience of three surgeons with the treatment of two-part surgical neck fractures with angular-stable intramedullary fixation.
  
  
  METHODS
  Forty-eight patients with forty-eight Neer two-part surgical neck proximal humeral fractures were managed with locked angular-stable intramedullary nail fixation by three surgeons. Shoulder pain and outcomes were quantified with Constant scores and standard radiographs.
  
  
  RESULTS
  Thirty-eight patients (including twenty-eight female patients and ten male patients) with a mean age of sixty-five years were followed for at least twelve months (mean, twenty months; range, twelve to thirty-six months). All fractures healed primarily. The mean follow-up Constant score (and standard deviation) was 71 ± 12 points (range, 37 to 88 points), with a mean age-adjusted Constant score of 97% (range, 58% to 119%). The mean Constant pain score was 13 ± 2.2 (possible range, 0 to 15 points, with 15 points representing no pain). The mean forward flexion was 132° ± 22°. All fractures but one healed with a neck-shaft angle of ≥125°.
  
  
  CONCLUSIONS
  Patients who were managed with locked angular-stable intramedullary nailing of two-part surgical neck proximal humeral fractures via an articular entry point had reliable fracture-healing, favorable clinical outcomes, and little residual shoulder pain.
authors.affiliation: Western Orthopaedics PC, 1830 Franklin Street, Denver, CO 80218, USA. Armandhatzi@yahoo.com
authors.forename: Armodios M
authors.initials: AM
authors.lastname: Hatzidakis
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Shevlin
authors.forename: Duane L
authors.initials: DL
authors.lastname: Fenton
authors.forename: Douglas
authors.initials: D
authors.lastname: Curran-Everett
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Nowinski
authors.forename: Edward V
authors.initials: EV
authors.lastname: Fehringer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome