title: Marchetti Vicenzi elastic retrograde nail in the treatment of humeral shaft fractures: review of the current literature.
abstract: Shoulder impairment following anterograde intramedullary nailing for humeral shaft fractures represents a challenging problem for the orthopedic surgeon. Traditional retrograde nailing lowers the rates of shoulder impairment although exposing the surgeons to severe technical issues related to the proximal interlocking. The Marchetti Vicenzi nail (MVN) permits a retrograde insertion along with a self-locking mechanism that lowers the risk of iatrogenic damage during proximal interlocking. Aim of this literature review was to evaluate all the case series dealing with MVN and the obtained results in terms of union rates, complications, and functional outcomes in order to evaluate evidence that would substantiate the adoption of MVN in the treatment of humeral shaft fractures. A search was performed using the keywords "humeral shaft fracture nail," "humeral retrograde nail," "humeral elastic nail," "Marchetti Vicenzi nail," "Marchetti nail," "Vicenzi nail." After accurate revision 13 articles found to be relevant with a total of 532 humeral fractures (traumatic and pathologic) and non-unions treated with MVN. The cumulative healing rate reported is 93.7 % with 6.3 % of non-unions. Despite the fact that obtained results compare favorably to the published data on the outcome of anterograde nailing, the evaluated studies presented a huge number of methodological flaws, thus making it difficult to recommend the adoption of MVN in preference of other better-validated forms of treatment.
authors.affiliation: Istituto Ortopedico Rizzoli - Dipartimento Rizzoli-Sicilia, Bagheria, PA, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ruffilli
authors.affiliation: Istituto Ortopedico Rizzoli - Dipartimento Rizzoli-Sicilia, Bagheria, PA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Traina
authors.affiliation: Istituto Ortopedico Rizzoli - Dipartimento Rizzoli-Sicilia, Bagheria, PA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pilla
authors.affiliation: Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Policlinico Universitario "G.Martino", Messina, ME, Italy. dfenga@gmail.com.
authors.forename: D
authors.identifier: http://orcid.org/0000-0002-4577-8719
authors.initials: D
authors.lastname: Fenga
authors.affiliation: Istituto Ortopedico Rizzoli - Dipartimento Rizzoli-Sicilia, Bagheria, PA, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Faldini
mesh_terms: D001858:Bone Nails; D019317:Evidence-Based Medicine; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: Elastic retrograde nail; Humeral shaft fractures; Review