Antegrade intramedullary interlocking nailing for midshaft humerus fractures: A retrospective study evaluating functional and radiological outcome

Abstract

Background: The incidence of humeral shaft fracture has significantly increased during the past decade due to the rising population and the number of road traffic accidents. Numerous surgical implants have been devised in order to achieve a stable fixation and early mobilization. Plating is considered as the gold standard for humerus shaft fracture fixation. With the advancement in nailing techniques and newer nail design, there is a shift of trend in the treatment of diaphyseal fractures towards use of nails by the trauma surgeons. The aim of this study was to evaluate the functional outcome of acute humeral shaft fractures undergoing fixation by intramedullary interlocking (IMIL) nails. Materials and Methods: 52 patients (mean age: 29.42 years) with acutely displaced midshaft humeral fractures who underwent intramedullary nailing (Sharma antegrade IMIL Humeral Nail) were retrospectively studied. They were assessed radiologically for fracture union and functional outcome using Constant and Murley Shoulder Score, American shoulder and Elbow Surgeons (ASES) score, and Mayo Elbow Performance score. Results: The mean Constant–Murley score and ASES score at a mean follow-up period of 4.6 years (range: 1–11.3 years) were 87.4 ± 11.2 and 92 ± 1.45, respectively. Out of 52 patients, 6 patients had shoulder impingement, 3 delayed union, 1 had nonunion, and 1 periarthritis of shoulder. Conclusion: Intramedullary nail fixation in the humeral shaft fracture is a minimally invasive procedure with excellent functional and radiological outcome. The results are comparable with that of plating which is considered as the gold standard.