Expandable nail system for osteoporotic humeral shaft fractures: Preliminary results

Background: Conventional nails rely on interlocking screws for axial and rotational stability. Such screws have poor fixation in patients with poor bone quality (osteopenia). The Fixion nail does not depend on interlocking screws-axial and rotational stability is instead achieved by nail expansion. Therefore, this nail may be better suited for patients with poor bone quality who require humeral stabilization. Methods: The system was used to manage 25 unstable humerus shaft fractures in osteoporotic bone. An antegrade approach was used in 18 patients and a retrograde approach was used in 7 patients. Results: There were no intra- or postoperative complications. Postoperatively, all fractures were stable and had healed by week 16. The mean operative time was 35 +/- 10 minutes (+/- SD) including 1.5 +/- 0.5 minutes of fluoroscopy time. Conclusion: The results of this study show that use of this nailing system is associated with minimal complications, predictable fracture healing, and excellent functional outcomes in a cohort of elderly patients with poor bone quality and Numeral shaft fractures requiring stabilization. Further confirmation by larger prospective trials is necessary.