Abstract
The goal of this study is to evaluate surgical treatment outcomes of fracture shaft humerus by using intramedullary interlocking nail. Fifteen patients (ages ranged from 51 to 70 with an average age of 64.20 ± 6.338 years, (10 males and 5 females) with shaft humeral fractures from Beni-Suef University and General hospitals during the period from December 2012 to June 2014. The selected participants were treated with intramedullary interlocking nail. Patients were followed up for a mean of 9 (range 6–12) months. The mean length of hospital stay was 3 (range 1–5) days. All the fractures united radiographically after a mean of 14 (range, 12–20) weeks. Conclusion: That the majority of humeral shaft fractures can be treated safely and effectively by non-operative methods. However, for the subset of patients requiring surgical treatment, intramedullary nailing provides predictable means of achieving fracture stabilization and ultimate healing. Poor outcome in intramedullary interlocking nailing is attributable to rotator cuff tear and shoulder impingement and lack of expertise of surgeon.
Highlights
Humeral shaft fractures make up approximately 3% of all fractures. [1] Typically, they are the result of direct trauma and occur in sports where rotational forces are greater, for example, baseball or arm wrestling
An interlocking intramedullary nail has been reported to produce satisfactory results with less soft tissue injury, relatively percutaneous insertion as well as biomechanical advantages; its entry may lead to rotator cuff tear and proximal the nail may creat shoulder impingement and decrease shoulder abduction and distally may lead to problem of elbow extention. [6]
This present study includes 10 males (66.6%) and 5 females (33.3%), with ages ranged from 20-60 years old
Summary
Humeral shaft fractures make up approximately 3% of all fractures. [1] Typically, they are the result of direct trauma and occur in sports where rotational forces are greater, for example, baseball or arm wrestling. Compression plate fixation, which is a widely accepted operative method gives a high union rate and allows early active motion of the joints, is technically demanding and requires extensive surgical dissection with risk of injury to the radial nerve. An interlocking intramedullary nail has been reported to produce satisfactory results with less soft tissue injury, relatively percutaneous insertion as well as biomechanical advantages; its entry may lead to rotator cuff tear and proximal the nail may creat shoulder impingement and decrease shoulder abduction and distally may lead to problem of elbow extention. [7] The plate is inserted by a percutaneous approach with separate proximal and distal incisions This method requires less soft tissue disruption and preserves the fracture haematoma and blood supply to the bone fragments, percutaneous plate insertion in humeral shaft fractures seems to be a less dangerous procedure regarding radial nerve injury.
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