Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term.
Fixation
Humeral fractures
Humeral nailing
Nail design
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
20 Oct 2021
20 Oct 2021
Historique:
received:
10
08
2021
accepted:
05
10
2021
entrez:
21
10
2021
pubmed:
22
10
2021
medline:
28
1
2022
Statut:
epublish
Résumé
Although proximal and diaphyseal humerus fractures are frequent, the optimal management remains controversial. Antegrade nailing prevents further damage to the soft tissues and to the vascularization, but it has been associated with postoperative shoulder pain and dysfunction. During the latest years a straight nail design was developed to minimize these problems. A total of 243 patients who had undergone surgery for antegrade intramedullary humeral nailing between January 2013 and July 2018 in A. Gemelli Trauma Center were divided into two groups according to the nail design used: straight nail group (S-group) and curvilinear nail group (C-group). Clinical data were collected using assessment forms (SF12-v2, Quick-DASH, ASES and Constant-Murley). Radiographic bone healing was assessed with RUST score at 30, 90 and 180 days after surgery. The S-group was made up of 128 patients with a mean age of 59 ± 19 (range 18-97) and a mean follow-up of 46 ± 9 months. The C-group was made up of 115 patients with a mean age of 53 ± 16 (range 18-88) and a mean follow-up of 51 ± 8 months. The S-group had a mental component summary (MCS) score of 54.3 ± 7.7 and a physical component summary (PCS) score of 46 ± 10.2, the C-group had a MCS score of 50.9 ± 8.4 and a PCS score of 44.1 ± 7.4. Quick-DASH and ASES were respectively 18.8 ± 4.3 and 78.6 ± 8.2 in the S-group, 28.3 ± 11.6 and 72.1 ± 13.5 in the C-group with statistical significance. Constant-Murley score was 73.9 ± 9.1 in the S-group (76% of the contralateral healthy side) and 69.4 ± 10.4 in the C-group (73% of the contralateral healthy side). The radiographic union score in the S-group was 4.1 ± 0.3 at 30 days after surgery, 7 ± 0.8 at 90 days and 10 ± 1.2 at 180 days, while in the C-group it was 4.2 ± 0.4 at 30 days, 6.4 ± 0.7 at 90 days and 9 ± 0.9 at 180 days. Newer generation straight nails allow a faster bone healing and better functional outcome at mid-term follow up. Level of evidence III.
Identifiants
pubmed: 34670577
doi: 10.1186/s13018-021-02776-w
pii: 10.1186/s13018-021-02776-w
pmc: PMC8529842
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
631Informations de copyright
© 2021. The Author(s).
Références
Am J Ind Med. 1996 Jun;29(6):602-8
pubmed: 8773720
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1):42-54
pubmed: 18308203
J Bone Joint Surg Am. 1984 Jun;66(5):639-46
pubmed: 6725312
J Shoulder Elbow Surg. 2016 May;25(5):e130-8
pubmed: 26895601
Clin Interv Aging. 2017 Nov 29;12:2047-2054
pubmed: 29238180
Orthop Traumatol Surg Res. 2020 Feb;106(1):17-23
pubmed: 31882328
J Orthop Trauma. 2018 Jan;32 Suppl 1:S1-S170
pubmed: 29256945
Injury. 2014 Jan;45 Suppl 1:S9-S15
pubmed: 24262669
Clin Orthop Relat Res. 1987 Jan;(214):160-4
pubmed: 3791738
J Bone Joint Surg Br. 2011 Jan;93(1):1-11
pubmed: 21196536
Orthopedics. 2008 Jan;31(1):42-51
pubmed: 18269167
J Bone Joint Surg Br. 2000 Apr;82(3):336-9
pubmed: 10813165
Clin Orthop Relat Res. 2012 Feb;470(2):602-9
pubmed: 21879402
J Shoulder Elbow Surg. 2011 Jul;20(5):795-801
pubmed: 21195633
Arch Orthop Trauma Surg. 2007 Dec;127(10):937-44
pubmed: 17901964
Clin Orthop Relat Res. 2006 Jan;442:87-92
pubmed: 16394745
Injury. 2020 Aug;51 Suppl 3:S34-S38
pubmed: 32430196
J Bone Joint Surg Am. 2003 Nov;85(11):2103-10
pubmed: 14630838
J Shoulder Elbow Surg. 2014 Mar;23(3):369-76
pubmed: 24291047
J Bone Joint Surg Br. 2006 Nov;88(11):1469-73
pubmed: 17075092
Injury. 2018 Oct;49(10):1750-1757
pubmed: 30017183
Med Care. 1996 Mar;34(3):220-33
pubmed: 8628042
J Trauma. 2010 Mar;68(3):629-32
pubmed: 19996801
J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):587-94
pubmed: 12469084
J Shoulder Elbow Surg. 2011 Dec;20(8):1241-7
pubmed: 21420325
Injury. 2006 Aug;37(8):691-7
pubmed: 16814787
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017713934
pubmed: 28625096
J Int Med Res. 2018 Nov;46(11):4363-4376
pubmed: 30270807
Injury. 2019 Nov;50(11):1978-1985
pubmed: 31405519
J Bone Joint Surg Am. 2007 Oct;89 Suppl 3:44-58
pubmed: 17908870
Expert Rev Med Devices. 2017 Sep;14(9):733-739
pubmed: 28792243
Oper Orthop Traumatol. 2012 Sep;24(4-5):418-31
pubmed: 23015093
Injury. 2020 Oct;51(10):2245-2252
pubmed: 32624208
Patient Saf Surg. 2014 Apr 22;8:18
pubmed: 24817909