Abstract
Background: The aim of this study was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on ahumerus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From April 2010 to April 2015, 30 patients were enrolled with humeral shaft fractures who were operated on using intra medullary humerus nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the humerus nail: in group 1, a single interlocking distal screw was used in 16 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. Shoulder function of patients wereassessed by modified American Shoulder and Elbow Surgeons (ASES) score. Results: We found that 15 (93.7%) fractures achieved union in group 1, and 13 (92.8%) of fractures, in group 2. There was no meaningful difference in the time to bone union and the recovery of displaced fracture fragments between the two groups. At the final follow-up, we found that the scores for shoulder joint modified ASES was 76.2 for group 1 and 79. 1 for group 2. Conclusions: This study shows that if locked appropriately, even a single screw on a humerusnail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.
Highlights
Long term survivorship in total knee replacement [TKR] is significantly dependant on prosthesis alignment
If the Error intibial tray alignment was more than +2o, it was considered as varus deformity [tibial component angle 92o]
We conclude that intramedullary tibial referencing guide can be used in TKR with great accuracy (91.48%) to achieve desired coronal plane tibial component alignment (90o ±2o)
Summary
Long term survivorship in total knee replacement [TKR] is significantly dependant on prosthesis alignment. In a standard total knee replacement, tibial component alignment is a key factor for the long-term success of the surgery. Conclusions: Intramedullary tibial referencing guide can be used in TKR with great accuracy (91.48%) to achieve desired coronal plane tibial component alignment (90o ±2o). In a standard TKR, tibial component alignment [TCA] is a key factor for the long term success of the surgery [3,4,5]. This becomes more so important when we are using gap balancing technique. The gold standard guide for achieving coronal plane alignment for the femoral cut is intramedullary jig [9,10], a few popular choices exist for tibial cuts such as conventional intramedullary jig, conventional extra medullary jig or computer assisted navigation
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