Is antegrade nailing a proper option in 2- and 3-part proximal humeral fractures?

被引：13
作者：
Congia S. [1 ]
Palmas A. [1 ]
Marongiu G. [1 ]
Capone A. [1 ]
机构：
[1] Clinica Ortopedica, Università degli Studi di Cagliari, Viale Lungo Mare Poetto 12, Cagliari, Sardegna
来源：
MUSCULOSKELETAL SURGERY | 2020年 / 104卷 / 2期
关键词：
Fractures; Intramedullary nailing; Outcomes; Proximal humerus; Shoulder; Treatment;
D O I：
10.1007/s12306-019-00610-5
中图分类号：
学科分类号：
摘要：
Purpose: To report our experience with antegrade short locked intramedullary nail for treatment of proximal humeral fractures and to review the current literature. Materials and methods: From January 2012 to July 2013, 41 patients affected by two and three-part proximal humeral fractures were treated with surgical internal fixation with short locked intramedullary nails. Outcome analysis included standard clinical follow-up, Constant shoulder score and plain radiographs. The mean follow-up was 30 months (range 24–42). Moreover, a review of the literature was carried out. Results: The mean Constant shoulder score was 81.5, excellent functional outcomes in 24/38 patients. All the fractures healed in an average time of 3.7 months. Five patients underwent additional operations, complications included hardware penetration into the joint (n = 2), backed out screw (n = 1), shoulder impingement due to protrusion of the nail (n = 2) and superficial infection (n = 1). The literature review showed 530 patients affected by proximal humeral fracture and treated with intramedullary nail with mean age of 65 years, mean follow-up of 22.2 months and a Constant shoulder score of 72.9 points; the major complications reported were backing out of the screws, shoulder impingement and joint protrusion of the screws. Conclusions: Antegrade short locked intramedullary nail allows stable fixation, minimal soft tissue dissection, early mobilization of the shoulder and good outcomes. It is an efficacious therapeutic solution for 2- and 3-part proximal humeral fractures. © 2019, Istituto Ortopedico Rizzoli.
引用
收藏
页码：179 / 185
页数：6
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