Proximal Humeral Fractures and Intramedullary Nailing: Experience with a New Nail System

摘要

Objectives: The goal of this study was to evaluate fracture healing and alignment as well as functional outcome and complication risks after internal fixation with the intramedullary proximal humeral nail (PHN). This device shows promise for applications involving the reconstruction of the humeral shaft and head with minimal soft tissue stripping and for providing a locked, fixed-angle construct for secure fixation to permit controlled, early, and active rehabilitation. Design: Prospective case-series. Setting: Multicenter study in 11 trauma units. Patients: One-hundred and fifty-one patients were treated for the same number of proximal humerus fractures.Intervention: Open reduction and internal fixation with the intramedullary PHN. Main Outcome Measurements: Occurrence of postoperative complications during and up to 1 year of follow-up. The patients were actively followed up for 1 year with radiological assessment to observe fracture healing, alignment, reduction, and necrosis and by functional outcome measurements, including Constant, Disabilities of the Arm, Shoulder and Hand (DASH), and Neer scores.