Outcome after Interlocking intramedullary nailing of humeral shaft fractures

  • Dr. Ashwani Ummat Associate Professor, Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
  • Dr. Sonia Kochhar Professor, Department of Physiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
  • Dr. Kunal Bansal PG Resident, Department Of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
  • Dr. Rahul Bhardwaj PG Resident, Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
  • Dr. Chetan Sharma PG Resident, Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India
Keywords: Complications, Humeral fractures, Intramedullary Interlocking Nailing

Abstract

Introduction: Management of fractures of humeral shaft is always a challenging problem to deal with as they are very frequently associated with multiple injuries, leading to complications. Interlocking intramedullary nails have gained popularity now a days for stabilization of humeral shaft fractures due to load sharing nature of implant, preservation of fracture haematoma, minimal exposure and rigid fixation with early mobilization.

Material & Methods: A prospective clinical study on fifty patients of humeral shaft fractures was performed using antegrade locked intramedullary nailing in our hospital setting to evaluate the incidence of complications associated with this method of humeral shaft fracture fixation.

Results: Superficial wound infection occurred in four cases (8%). Shortening of one cm was observed in one case (2%) and troublesome shoulder pain remained in two patients (4%). Persistent restriction of shoulder movements remained in twelve patients (24%) at 6 months, non-union occurred in two patients (4%), iatrogenic transient radial nerve palsy occurred in four patients (8%). Two patients (8%) developed myositis ossificans of shoulder joint and two patient (8%) developed hypertrophy of scar.

Conclusion: A number of technical errors and complications, which we consider technique specific, were registered. The analysis and avoidance of these complications, related to intramedullary nailing of the humerus, will allow intramedullary nails to successfully bridge the gap between bracing and plating.

Downloads

Download data is not yet available.

References

1. Bleeker WA, Nijsten MW, ten Duis HJ (1991) Treatment of humeral shaft fractures related to associated injuries. A retrospective study of 237 patients. Acta Orthop Scand 62(2): 148–53.

2. Wallny T, Westermann K, Sagebiel C, Reimer M, Wagner UA. Functional treatment of humeral shaft fractures: Indications and results. J Orthop Trauma. 1997 May;11(4):283-7.

3. Vander Griend R, Tomasin J, Ward EF. Open reduction and internal fixation of humeral shaft fractures. Results using AO plating techniques. J Bone Joint Surg Am 1986; 68(3):430-3.

4. Heim D, Herkert F, Hess P, Regazzoni P. Surgical treatment of humeral shaft fractures - the Basel experience. J Trauma. 1993;35(2):226–232.

5. Crates J, Whittle AP. Antegrade interlocking nailing of acute humeral shaft fractures. Clin Orthop Relat Res. 1998;(350):40–50.

6. Scheerlinck T, Handelberg F. Functional outcome after intramedullary nailing of humeral shaft fractures: Comparison between retrograde Marchetti-Vicenzi and unreamed AO antegrade nailing. J Trauma 2002; 52:60-71. http://journals.lww.com/jtrauma/Abstract/2002/01000/Functional_Outcome_after_Intramedullary_Nailing_of.12.aspx

7. Riemer BL, Butterfield SL, D'Ambrosia R, Kellam J. Seidel intramedullary nailing of humeral diaphyseal fractures: a preliminary report. Orthopedics. 1991 Mar;14(3):239–246.

8. Balfour GW, Mooney V, Ashby ME. Diaphyseal fractures of the humerus treated with a ready-made fracture brace. J Bone Joint Surg 1982;64A:11-3.

9. Sarmiento A, Kinman PB, Galvin EG, Schmitt RH, Phillips JG. Functional bracing of fractures of the shaft of the humerus. J Bone Joint Surg Am. 1977;59(5):596–601.

10. Brumback R.J., Gosse M.J., Poka A., Burgess A.R. Intramedullary stabilization of humeral shaft fractures in patients with multiple trauma. J Bone Jt Surg. 1986;68A:960–970.

11. Henley M.B., Chapman J.R., Claudi B.F. Closed retrograde Hackethal nail stabilization of humeral shaft fractures. J Orthop Trauma. 1992; 6:18–24.

12. Ikpeme JO. Intramedullary interlocking nailing for humeral fractures. Experiences with Russell-Taylor humeral nail. Injury 1994; 25:447-455.

13. Hems TE, Bhullar TP. Interlocking nailing of humeral shaft fractures; the Oxford Experience 1991 to 1994. Injury 1996; 27:485-489. http://www.sciencedirect.com/science/article/pii/0020138396000563

14. Lin J, Hou SM. Antegrade locked nailing for humeral shaft fractures. Clin Orthop Relat Res. 1999;(365):201–210.

15. Rommens PM, Verbruggen J, Broos PL. Retrograde locked nailing of humeral shaft fractures. A review of 39 patients. J Bone Joint Surg Br. 1995;77(1):84–89.

16. Crolla RMPH, de Vries LS, Clevere GJ. Locked intramedullary nailing of humeral fractures.Injury 1993; 24:403-406.

17. Cox M, Dolan M, Synnott K, McElwain JP. Closed interlocking nailing of humeral shaft fractures with Russell-Taylor nail. Journal of Orthopaedic Trauma 2000; 14(5): 349-353. http://journals.lww.com/jorthotrauma/Abstract/2000/06000/Closed_Interlocking_Nailing_of_Humeral_Shaft.8.aspx

18. Robinson CM, Bell KM, Court-Brown CM, McQueen MM (1992) Locked nailing of humeral shaft fractures: Experience in Edinburgh over a two year period. J Bone Joint Surg [Br] 74:558–562.
CITATION
DOI: 10.17511/ijmrr.2016.i05.25
Published: 2016-05-31
How to Cite
1.
Ummat A, Kochhar S, Bansal K, Bhardwaj R, Sharma C. Outcome after Interlocking intramedullary nailing of humeral shaft fractures. Int J Med Res Rev [Internet]. 2016May31 [cited 2024Nov.23];4(5):803-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/560
Section
Original Article