title: Closed retrograde multiple intramedullary Kirschner wires fixation for humeral shaft fractures with the limb flexed over an articulated support.
abstract: OBJECTIVE
  To evaluate the results of multiple closed intramedullary Kirschner wiring via a supracondylar entry point for humeral shaft fractures.
  
  
  METHODS
  The charts of 37 patients with humeral shaft fractures treated with the Hackethal's technique between January 2007 and December 2011 were reviewed retrospectively. The operation was performed with the patient lying in supine (n = 22) or lateral (n = 15) position. The elbow was flexed over an articulated support with the arm kept in a vertical position. Thirty-three patients were available for final evaluation with a mean follow-up delay of 14 (range, 6-24) months. We were concerned about fracture union, range of motion of the shoulder and the elbow, and complications. Final evaluation used the criteria by Qidwai.
  
  
  RESULTS
  Bone union rate was 94%. Restriction of ranges of motion of the shoulder more than 20° was noticed in two patients due to protruding wires. Three patients developed limitation of elbow extension owing to backing out of the wires. The overall results were excellent (n = 26; 79%), good (n = 4; 12%), and poor (n = 3; 9%).
  
  
  CONCLUSIONS
  Closed Hackethal's technique using K-wires gives satisfactory results in terms of bone union and elbow and shoulder function in selected humeral shaft fractures. The articulated support precludes the transolecranon traction.
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: Essoh J B
authors.initials: EJ
authors.lastname: Sié
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: Aka D
authors.initials: AD
authors.lastname: Kacou
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Traoré
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: C
authors.initials: C
authors.lastname: Mobiot
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: I
authors.initials: I
authors.lastname: Bamba
authors.affiliation: Department of Orthopedics Surgery, Yopougon University Teaching Hospital, 21 BP 632 Abidjan 21, Cote d'Ivoire.
authors.forename: Y
authors.initials: Y
authors.lastname: Lambin
keywords: Hackethal's technique; Humeral shaft fracture; Intramedullary fixation; Skeletal traction