Title: Surgical Management of Fracture Shaft of Humerus in Adults Using Flexible Nails – By Retrograde Technique
Authors: Dr Harish Y S, Dr Pradeepkumar, Dr Ananth H S
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.11
DIDS : 08.2015-73434383
Background and Objective:The fractures of the shaft of humerus are one of the commonest fractures found and can be treated by different methods. The present study is undertaken to know the functional outcome following the use of flexible nails for humeral shaft fractures in adults. Materials and Methods: It is a prospective study which was carried out from August 2012 to July 2014 J.J.M.Medical College, Davangere. In this study period 20 cases of fracture shaft of the humerus were treated by closed reduction and internal fixation using flexible nails. Results: In our series, majority of the patients were males(70%), middle aged, with road traffic accidents(70%) being the commonest mode of injury, involving middle third(60%). Average follow up ranged from 6-18 months,60% united in 14-18 weeks duration, 3patient had delayed union,1 patient had non-union, 1 patient had implant breakage. 95% recovered with full range of elbow movements. The average ASES score was 50. 70% had excellent results,10% had good and 20% had poor results Conclusion: Flexible intramedullary nailing done by retrograde technique produces equally good results comparable to any plate osteosynthesis or interlocking intramedullary nailing. Another added advantage of flexible nail fixation is it requires very minimal operative instrumentation. Key Words: Humeral shaft fractures, Flexible nails, Closed reduction and Internal fixation 1. McKee MD, "Fractures of The Shaft of The Humerus" Rockwood & Green's Fractures in Adults, 6th Edition, Bucholz, Robert W.; Heckman, James D.; Court-Brown, Charles M. Lippincott 2006: 1118-1159. 2. Brinker MR, O'Connor DP. The incidence of fractures and dislocations referred for orthopaedic services in a capitated population. J Bone Joint Surg Am 2004; 86:290-297. 3. J.N.Wilson. Watson-Jones. Fractures and Joint Injuries, 6th ed. B.I. Churchill Livingstone PVT Ltd. New Delhi 2002. 4. C.L.Colton, A.Fernandez Dell'Oca, U.Holz, J.F.Kellam, P.E.Ochsner. AO Principles of Fracture Management: AO Publishers 2000. 5. Klenerman L. Fractures of the shaft humerus. J Bone Joint Surg Br 1966; 48: 105- 111. 6. Matthew W Lawless. Midshaft Humeral Fractures. e Medicine. 2004 July. Available from: URL: http:// www.emedicine.com/orthoped/topic199.htm 7. Wilairatana V,Prasongchin P.The open reduction and internal fixation of humeral diaphysis fracture treatment with a medial approach. J Med Assoc Thai 2001;84(1): 423-427. 8. Gongol T,Mracek D.Functional therapy of diaphyseal fractures of the humeral bone.Acta Chir Orthop Traumatol Cech 2002;69(4):248-253. 9. James W. Pritchett. Delayed union of humeral shaft fractures treated by closed flexible intramedullary nailing. 1985;67(5). 10. Tingstad EM. Wolinsky PR, Shyr Y, Johnson KD. Effect of immediate weight bearing on plated fractures of the humeral shaft. J trauma 2001;49(2):278-280. 11. Tytherleigh-Strong G,Walls N,McQueen MM. The epidemiology of humeral shaft fractures. J Bone Joint Surg 1998;80:249-53. 12. Bell MJ, Beauchamp CG, Kellan JK,McMutry RY.The result of plating humeral shaft fractures in patients with multiple injuries.J Bone Joint Surg Br 1985;67(2):293-296. 13. Griend RV, Tomasin J,Ward EF.Open reduction and internal fixation of humeral shaft fractures.J Bone Joint Surg Am 1986;68A:430-433. 14. McCormack RG,Brien D, Buckley RE, McKee MD, Powell J.Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail.J Bone Joint Surg Br 2000;82(3):336-39. 15. Heim D, Herkert F, Hess P, Regazzoni P. Surgical treatment of humeral shaft fractures, the basal experience. J Trauma 1993; 35:226-232. 16. Koch PP,Gross DF,Gerber C. The results of functional (Sarmiento) bracing of humeral shaft fractures.J Shoulder Elbow Surg 2002;11(2):143-147. 17. Ring D,Kloen P, Kadizielski J,Helfet D, Jupiter JB. Locking compression plates for the osteoporotic nonunions of the diaphyseal humerus.Clin Orthop Relat Res,2004 Aug;425:50-4. 18. Zuckerman JD,Koval KJ.”Fractures of the shaft of the humerus” Chap 15, In: Rockwood CA, Green DP, Buckolz RW, Heckman JD,eds. Fractures in adults.4rth ed.Philadelphia, PA:JB Lippincott 1996:1025-1051. 19. Rommens PM, Verbruggen J,Broos PL. Retrograde locked nailing of humeral shaft fractures.A review of 39 patients. J Bone Joint Surg 1995;77B:p.84-89. 20. Dayez J. Internal screwed plate for recent fractures of the humeral diaphysis in adults. Rev Chir Orthop Reparatrice Appar Mot 1999; 85(3): 238-44.Abstract
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