TY - JOUR
T1 - Angular-stable locked intramedullary nailing of two-part surgical neck fractures of the proximal part of the humerus
T2 - A multicenter retrospective observational study
AU - Hatzidakis, Armodios M.
AU - Shevlin, Michael J.
AU - Fenton, Duane L.
AU - Curran-Everett, Douglas
AU - Nowinski, Robert J.
AU - Fehringer, Edward V.
PY - 2011/12/7
Y1 - 2011/12/7
N2 - Background: The ideal fixation technique for the treatment of proximal humeral fractures remains unclear. In the present study, we evaluated the experience of three surgeons with the treatment of two-part surgical neck fractures with angular-stable intramedullary fixation. Methods: Forty-eight patients with forty-eight Neer two-part surgical neck proximal humeral fractures were managed with locked angular-stable intramedullary nail fixation by three surgeons. Shoulder pain and outcomes were quantified with Constant scores and standard radiographs. Results: Thirty-eight patients (including twenty-eight female patients and ten male patients) with a mean age of sixty-five years were followed for at least twelve months (mean, twenty months; range, twelve to thirty-six months). All fractures healed primarily. The mean follow-up Constant score (and standard deviation) was 71 ± 12 points (range, 37 to 88 points), with a mean age-adjusted Constant score of 97% (range, 58% to 119%). The mean Constant pain score was 13 ± 2.2 (possible range, 0 to 15 points, with 15 points representing no pain). The mean forward flexion was 132° ± 22°. All fractures but one healed with a neck-shaft angle of ≥125°. Conclusions: Patients who were managed with locked angular-stable intramedullary nailing of two-part surgical neck proximal humeral fractures via an articular entry point had reliable fracture-healing, favorable clinical outcomes, and little residual shoulder pain. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
AB - Background: The ideal fixation technique for the treatment of proximal humeral fractures remains unclear. In the present study, we evaluated the experience of three surgeons with the treatment of two-part surgical neck fractures with angular-stable intramedullary fixation. Methods: Forty-eight patients with forty-eight Neer two-part surgical neck proximal humeral fractures were managed with locked angular-stable intramedullary nail fixation by three surgeons. Shoulder pain and outcomes were quantified with Constant scores and standard radiographs. Results: Thirty-eight patients (including twenty-eight female patients and ten male patients) with a mean age of sixty-five years were followed for at least twelve months (mean, twenty months; range, twelve to thirty-six months). All fractures healed primarily. The mean follow-up Constant score (and standard deviation) was 71 ± 12 points (range, 37 to 88 points), with a mean age-adjusted Constant score of 97% (range, 58% to 119%). The mean Constant pain score was 13 ± 2.2 (possible range, 0 to 15 points, with 15 points representing no pain). The mean forward flexion was 132° ± 22°. All fractures but one healed with a neck-shaft angle of ≥125°. Conclusions: Patients who were managed with locked angular-stable intramedullary nailing of two-part surgical neck proximal humeral fractures via an articular entry point had reliable fracture-healing, favorable clinical outcomes, and little residual shoulder pain. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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U2 - 10.2106/JBJS.J.00754
DO - 10.2106/JBJS.J.00754
M3 - Article
C2 - 22159852
AN - SCOPUS:83455200022
SN - 0021-9355
VL - 93
SP - 2172
EP - 2179
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 23
ER -