Screw Intramedullary Nailing for Fractures of the Humeral Shaft

Y S Salphale,R M Chandak,Jayeshkumar Dave,W M Gadegone

doi:10.4236/ss.2015.68057

Abstract

The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedullary nails and achieve union with least trauma to the shoulder and the rotator cuff. The multiple elastic screw nails achieve the inherent stability based on the principle of “three point fixation”. We aim to propose that the screw intramedullary nail is an effective implant to facilitate uneventful fracture union, with rapid recovery, low morbidity and low learning curve capable of being replicated in any smaller operative set up.

Highlights

The humeral shaft fractures can be managed by closed reduction and casting as well as by a variety of surgical means
We aim to propose a technique, never used for the fractures of the humeral shaft, after seeking approval from the hospital ethics committee which could be undertaken at any district level hospital, with minimum instrumentation with a relatively low learning curve
The screw intramedullary nail seems to be a good technique of fixation with low risk of infection, minimal cost, promoting faster healing because the blood supply is only altered insignificantly

Summary

Introduction

The humeral shaft fractures can be managed by closed reduction and casting as well as by a variety of surgical means. It is paradox why a surgical technique, so successful in the treatment of diaphyseal femoral and tibial fractures cannot produce similar results when applied in the humerus. A possible explanation is that the complex anatomy and the unique biomechanical characteristics of the humerus are often overlooked. With the advent of new tools and techniques the armamentarium of a trauma surgeon is enriched. We aim to propose a technique, never used for the fractures of the humeral shaft, after seeking approval from the hospital ethics committee which could be undertaken at any district level hospital, with minimum instrumentation with a relatively low learning curve

Objectives

Discussion

Conclusion