Complications of locked nailing in humeral shaft fractures
- VernacularTitle:交锁髓内钉固定治疗肱骨干骨折术后并发症分析
- Author:
Jian ZOU
;
Wei ZHANG
;
Yi ZHU
- Publication Type:Journal Article
- Keywords:
Fracture fixation, intramedullary;
Humeral fractures;
Postoperative complications
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective There are many methods to treat adult humeral shaft fracture. Plates fixation and intramedullary locking nail are two important methods. Though plate fixation are "gold criterion", there were many defects limited its development. With humeral intramedullary nail widely used, this study is to analysis and investigates the complications of locked nailing in humeral shaft fractures. Methods Between January 2000 and January 2004, 90 humeral shaft fractures (74 acute fractures and 16 delayed unions or nonunions) in 89 patients were treated with humeral intramedullary locking nails and followed up for an average of 25.4 months(12-34 months). There were 56 males and 33 females, with an average age of 39.3 years. Acute fractures included 62 closed, 7 Gustilo type Ⅰ, 3 type Ⅱ and 2 type Ⅲa open fractures. 12 nonunions had previous operations. 8 patients had radial nerve palsy. In general, acute fractures were treated with closed nailing and nonunions were treated with open nailing with bone grafting. 53 proximal humeral fracture were treated by antegrade nail, the others with distal humeral fracture were treated by retrograde nail. Results In total, 17 patients had 18 significant complications. 5 of them were persistent nonunions. There was no statistics difference between antegrade nail and retrograde nail. The others were protruded screws, fracture gap, shoulder impairment, elbow impairment, angular malunion, deep infection and postnailing radial nerve palsy. Conclusion The risk of operative comminution was significantly higher in retrograde nailing, and operative comminution resulted in a significantly higher risk of nonunion. Many complications of humeral locked nailing can be prevented by improving the implant design or surgical techniques.
