title: [Clinical and radiological results of fractures of the proximal humerus treated with intramedullary nailing and possible risk factors of a poor outcome].
abstract: BACKGROUND
  To assess the clinical and radiological results of fractures of the proximal humerus treated with intramedullary nail fixation as well as the risk factors associated with a poor outcome.
  
  
  METHODS
  Patients were analyzed retrospectively with a minimum follow-up of one year. An objective clinical assessment was made using the Constant scale, the subjective satisfaction scale, VAS, and the DASH scale to measure disability. The radiological assessment included AP and axial X-rays in the scapular plane.
  
  
  RESULTS
  Forty-six patients were enrolled. The clinical assessment showed that 91.3% of them were satisfied with treatment. Mean mobility was 1550 of flexion, 600 of lateral and medial rotation. The mean Constant score was 70 and the DASH score was 15. Significant differences were found in the Constant score in individuals under 60 years of age, but they were not significant considering the type of fracture or the DASH score. X-rays showed a healing rate of 95.7%, with two cases of pseudarthrosis. Varus healing was observed in 17 patients (38.6%). Functional differences were found when patients with varus healing were compared with those who had anatomical healing.
  
  
  CONCLUSIONS
  Fixation with intramedullary nailing is an effective treatment for fractures of the proximal humerus, particularly for two-segment fractures of the surgical neck. The high rate of varus collapse, particularly in very comminuted fractures, may lead to decreased mobility.
authors.forename: E
authors.initials: E
authors.lastname: Casado-Sanz
authors.forename: R
authors.initials: R
authors.lastname: Barco-Laakso
authors.forename: S
authors.initials: S
authors.lastname: Antuña-Antuña
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000601:surgery*; D018460:Fractures, Comminuted / Q000453:epidemiology; D006801:Humans; D006811:Humerus / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011542:Pseudarthrosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult