Chul-Hyun Cho; Gu-Hee Jung; Kyo-Wook Kim

doi:10.12671/jkfs.2011.24.3.237

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Original Article
Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus: Chul-Hyun Cho, M.D., Ph.D., Gu-Hee Jung, M.D., Kyo-Wook Kim, M.D.; Journal of the Korean Fracture Society 2011;24(3):237-242.
DOI: https://doi.org/10.12671/jkfs.2011.24.3.237
Published online: July 15, 2011

Department of Orthopaedic Surgey, School of Medicine, Keimyung University, Daegu, Korea.

^*Department of Orthopaedic Surgey, Gospel Hospital, Kosin University College of Medicine, Busan, Korea.

Address reprint requests to: Chul-Hyun Cho, M.D., Ph.D. Department of Orthopedic Surgery, School of Medicine, Keimyung University, 56, Dalsung-ro, Joong-gu, Daegu 700-712, Korea. Tel: 82-53-250-7729, Fax: 82-53-250-7205, oscho5362@dsmc.or.kr

• Received: May 5, 2011 • Revised: May 30, 2011 • Accepted: June 24, 2011

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the results of antegrade interlocking intramedullary nailing for complex fractures of the proximal and midshaft of the humerus.
Materials and Methods
We retrospectively analyzed the clinical and radiologic results in 11 cases, which were treated by antegrade interlocking intramedullary nail. We assessed clinical outcomes according to ASES scoring system and radiological result.
Results
All cases had bony union and the mean union period was 14.7 weeks. Postoperative complications were 1 loss of fixation, 2 proximal protrusion of nail and 2 temporary shoulder pain. A case with loss of fixation was treated open reduction and refixation and had union at 14 weeks postoperatively. The mean ASES score was 85.9 and the clinical outcomes were 4 excellent, 5 good, 1 fair and 1 poor.
Conclusion
Intramedullary nailing for complex fractures of the proximal and midshaft of the humerus can offer a reliable treatment option.
Key words: Proximal humerus, Shaft, Complex fracture, Intramedullary nailing

REFERENCES

1. Garnavos C, Lasanianos N. Intramedullary nailing of combined/extended fractures of the humeral head and shaft. J Orthop Trauma, 2010;24:199-206.
2. Halder SC, Chapman JA, Choudhury G, Wallace WA. Retrograde fixation of fractures of the neck and shaft of the humerus with the 'Halder humeral nail'. Injury, 2001;32:695-703.
3. Ingman AM, Waters DA. Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results. J Bone Joint Surg Br, 1994;76:23-29.
4. Kang HJ, Lee DY, Sung SY, Hahn SB. Intramedullary niling for the fracture of proximal humerus. J Korean Fract Soc, 2004;17:271-276.
5. Levy B, Herrera D, Templeman D, Cole P. Segmental proximal humerus fractures: a case report of submuscular plating. J Trauma, 2008;65:1554-1557.
6. Lin J, Hou SM. Locked nailing of severely comminuted or segmental humeral fractures. Clin Orthop Relat Res, 2003;406:195-204.
7. McCormack RG, Brien D, Buckley RE, McKee MD, Powell J, Schemitsch EH. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail. A prospective, randomised trial. J Bone Joint Surg Br, 2000;82:336-339.
8. Noh KC, Chung YK, Chung KJ, Hong SK. Two-part and three-part fractures of the proximal humerus treated with the polarus interlocking nail: a comparison of fracture types. J Korean Fract Soc, 2006;19:182-187.
9. Rancan M, Dietrich M, Lamdark T, Can U, Platz A. Minimal invasive long PHILOS®-plate osteosynthesis in metadiaphyseal fractures of the proximal humerus. Injury, 2010;41:1277-1283.
10. Srinivas S, Kasis A. Co-existing fractures of the proximal humerus and humeral shaft without shoulder dislocation--a rare injury. Ann R Coll Surg Engl, 2010;92:W25-W28.
11. Watanabe RS. Intramedullary fixation of complicated fractures of the humeral shaft. Clin Orthop Relat Res, 1993;292:255-263.
12. Yang KH. Helical plate fixation for treatment of comminuted fractures of the proximal and middle one-third of the humerus. Injury, 2005;36:75-80.

Fig. 1

Extended type, 51-year-old man.

(A) Preoperative radiographs show comminuted fracture of the proximal and shaft of right humerus.

(B) Postoperative radiographs show internal fixation using AO humeral nail.

(C) Radiograph at 9 months after the surgery show complete bony union.

Fig. 2

Segmental type, 23-year-old woman.

(A) Preoperative radiographs show segmental fracture of the proximal and shaft of right humerus.

(B) Postoperative radiographs show internal fixation using Polarus plus nail.

(C) Radiograph at 6 months after the surgery show complete bony union.

Fig. 3

Extended type, 55-year-old woman.

(A) Preoperative radiographs show fracture of the proximal 1/3 of right humerus.

(B) Radiographs at 5^th postoperative day show fixation failure after internal fixation using Polarus nail.

(C) Radiograph at 12 months after revision surgery show complete bony union.

Table 1

Demographic data

Table 2

Details of results and complications in 11 cases

Figure & Data

REFERENCES

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Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus

J Korean Fract Soc. 2011;24(3):237-242. Published online July 31, 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.3.237

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Figure

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Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus

Fig. 1 Extended type, 51-year-old man. (A) Preoperative radiographs show comminuted fracture of the proximal and shaft of right humerus. (B) Postoperative radiographs show internal fixation using AO humeral nail. (C) Radiograph at 9 months after the surgery show complete bony union.

Fig. 2 Segmental type, 23-year-old woman. (A) Preoperative radiographs show segmental fracture of the proximal and shaft of right humerus. (B) Postoperative radiographs show internal fixation using Polarus plus nail. (C) Radiograph at 6 months after the surgery show complete bony union.

Fig. 3 Extended type, 55-year-old woman. (A) Preoperative radiographs show fracture of the proximal 1/3 of right humerus. (B) Radiographs at 5th postoperative day show fixation failure after internal fixation using Polarus nail. (C) Radiograph at 12 months after revision surgery show complete bony union.

Fig. 1

Fig. 2

Fig. 3

Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus

Table 1

Demographic data

Table 2

Details of results and complications in 11 cases

Table 1 Demographic data

Table 2 Details of results and complications in 11 cases