[Fixation of proximal humeral fracture with proximal humeral locking intramedullary nail].

OBJECTIVES

To investigate the results of two-part surgical neck fractures of proximal humerus treated with locking intramedullary nail for proximal humerus, and to discuss the indication, surgical technique and the effectiveness.

METHODS

The data of the 22 patients with two-part surgical neck fractures fixed with proximal humeral nail was retrospectively reviewed. The mean age was 57 years. X-ray film and visual analogue scale (VAS), American shoulder and elbow surgeon (ASES) score, Constant-Murley score, University of California, Los Angeles (UCLA) scoring system and simple shoulder test (SST) questionnaire were used to evaluate the patients' shoulder function recovery at final follow-up.

RESULT

All the patients were followed up with an average time of 13 months. All fractures united within 8 weeks postoperatively. No infection, avascular necrosis or complications which concerning with hardware was found during follow-up. The average active forward flexion was 147.8 degrees , the average external rotation was 45.5 degrees and the average internal rotation was T10. The mean VAS score was 1.5. The mean ASES score, Constant-Murley score, UCLA score and SST score were 81.2, 85.4, 29.9 and 9.5 respectively. Eighteen patients were rated as "excellent" or "good", while 4 others were rated "poor". All patients were satisfied with their results.

CONCLUSION

With good indication control, meticulous intraoperative management and strict postoperative rehabilitation, close reduction and internal fixation with proximal humeral nail can be an effective method for the treatment of two-part surgical neck fracture.