Abstract
Introduction: Complex humerus fractures is a frequent lesion with a greater incidence than hip fractures. The treatment is a challenge for orthopaedic surgeons. We present a new osteosynthesis technique based on a mini invasive nailing with a self stabilized screws interlocking.
Methods: We used a 15 cm intramedullary nail with a 7, 8, or 9 mm width. The proximal locking is carried out in the articular and tuberosity fragments with cancellous screws. Two or three small fragments long threaded screws are usually necessary to stabilize the fragments and the humeral head. Rigid fixation is obtained with an excellent stability due to the intra nail locking of the screws. Distal interlocking is carried out at the level of the deltoid tuberosity ensured by 1 or 2 frontal screws introduced away from the nerves and blood supply. Functional therapy is initiated on the first post-operative day.
Results: We present a series of the first 64 cases done in a prospective approach. The patients have been classified according to the Constant score. The mean balanced score is 88% at the two years follow-up. Among the advantages of the technique we point out the great comfort of the patients with a minimal pain and the possibility of an immediate rehabilitation after the surgery. Because of the use of the nail, we stop the use of the hemiarthroplasty even in the 4 fragments fractures.
Conclusion: Telegraph nailing of the complex proximal humeral fractures gives excellent results at the two years follow-up, sometimes unexpected even in the more complex cases and avoid the use of shoulder arthroplasty in the traumatic indication.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
