Document Detail

Central-medullary nailing of proximal humerus fractures using T2 nails. A retrospective study of 38 cases
MedLine Citation:
PMID:  20207182     Owner:  NLM     Status:  MEDLINE    
The intramedullary nailing of humerus has emerged as one of the treatments of reference for proximal fractures. We have reviewed 38 patients aged 64.2 on average with a mean follow of 18 months. The functional scores used were the Constant and Murley's score as well as the DASH self-administered quality of life questionnaire. Radiological criteria have been analyzed, namely the cephalic angle noted alphaF and the presence of any osteolysis of the major tuberosity. Patients were grouped by type of fracture, according to Neer's classification, with nine cases in Neer 2 group, 19 in Neer 3 group, and ten in Neer 4 group. The unrefined Constant score was 53.4 points on average, balanced to 71.6%. The joint mobilities were an average forward elevation of 108 degrees, an average abduction of 100 degrees and an external rotation of 27 degrees. These scores were even worse than the fracture was comminuted. It was not found a radioclinical correlation between value of the angle alphaF and clinical outcome, but the presence of osteolysis of the major tuberosity was significantly associated with poor late functional results. Five cases of osteonecrosis have been counted, divided with 10.5% in the Neer stage 3, and 30% in the Neer stage 4. The average unrefined Constant score from these patients was 38.5 points on average, balanced to 57.7%. Intramedullary nailing allows fixation of comminuted fractures with three or four fragments, but control of fixing and strength of assembly were not always practiced. In young patients, where tuberosities consolidation is essential, screwed plates seem to be a favorable alternative. Moreover, total reverse prosthesis seems to have more and more arguments to impose itself like the preferred treatment towards fractures in four fragments in people aged over 75 years.
G Gaumet; O Boniface; G Wavreille; M Leroy; T Vervoort; C Chantelot
Publication Detail:
Type:  English Abstract; Journal Article     Date:  2010-02-10
Journal Detail:
Title:  Chirurgie de la main     Volume:  29     ISSN:  1769-6666     ISO Abbreviation:  Chir Main     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100937750     Medline TA:  Chir Main     Country:  France    
Other Details:
Languages:  fre     Pagination:  58-66     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Masson SAS. All rights reserved.
Service de chirurgie traumatologique, CHRU de Lille, Lille, France.
Vernacular Title:
Enclouage centromédullaire des fractures de l'extrémité proximale de l'humérus par clou T2. Etude rétrospective de 38 cas.
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MeSH Terms
Activities of Daily Living / psychology
Aged, 80 and over
Bone Nails*
Fracture Fixation, Intramedullary / adverse effects,  instrumentation*,  methods
Fracture Healing
Fractures, Comminuted / surgery
Middle Aged
Osteonecrosis / etiology
Prosthesis Design
Quality of Life / psychology
Range of Motion, Articular
Reflex Sympathetic Dystrophy / etiology
Retrospective Studies
Shoulder Fractures / classification,  psychology,  radiography,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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