title: A new nail with a locking blade for complex proximal humeral fractures.
abstract: BACKGROUND
  The objective of this study was to assess the clinical outcome of displaced proximal humerus fracture treated with a new locking blade nail.
  
  
  METHODS
  This prospective study included a series of 92 patients with acute fracture of the proximal humerus treated in one hospital level I trauma centre with locking blade nail between December 2010 and December 2013. According to the Neer classification, all fractures were two- to four-part fractures. Age adopted Constant score, DASH and visual analogue scores were used as outcome measures.
  
  
  RESULTS
  A total of 92 patients were enrolled in the study. However, 29 patients were excluded due to loss to follow-up and death. Ultimately, 63 patients were available for final follow-up and data analysis. The mean duration of follow-up was 22 months (range 16-48 months). On average at 1 year, all fractures had united. The mean weighted Constant score was 84.2 % and the median disabilities of the arm, shoulder and hand (DASH) score was 26, the range of elevation was 115 and range of abduction was 97. The head shaft angle was 130, and pain visual analogue was 1.6. We found that 5 of the 63 patients (8 %) demonstrated complications. Two patients (3 %) displayed secondary displacement and require device removal. Two patients (3 %) had impingement due to prominent metal work, and one patient had a superficial wound infection which was treated with a course of antibiotics.
  
  
  CONCLUSIONS
  Our study shows excellent results with new locking blade nail for displaced proximal humerus fractures. We think the locking blade nail offers stiff triangular fixation of the head fragment and support of the medial calcar region to prevent secondary varus collapse.
  
  
  METHODS
  III.
authors.affiliation: Warwick Hospital, Lakin Road, Warwickshire, CV34 5BW, UK. hashmi@btinternet.com.
authors.forename: F R
authors.identifier: http://orcid.org/0000-0003-0584-7545
authors.initials: FR
authors.lastname: Hashmi
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Klinikum Augsburg, Stenglinstr.2, 86156, Augsburg, Germany.
authors.forename: Edgar
authors.initials: E
authors.lastname: Mayr
mesh_terms: D000368:Aged; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D000072039:Fracture Dislocation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D005858:Germany; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009262:Nails; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Calcar; Functional outcome; Insufficient primary stability; Locked blade; Minimal soft tissue damage; Outcome measures; Proximal humeral fractures; Rotator cuff; Triangular fixation