Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures

Yum,  Jae Kwang; Lim,  Dong Ju; Jung,  Eui Yub; Sohn,  Su Een

doi:2013.16.2.107

Clin Shoulder Elb > Volume 16(2); 2013 > Article

Original Article

Clinics in Shoulder and Elbow 2013;16(2):107-114.
DOI: https://doi.org/10.5397/CiSE.2013.16.2.107 Published online December 31, 2013.

Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures

Jae Kwang Yum, Dong Ju Lim, Eui Yub Jung, Su Een Sohn

Department of Orthopaedic Surgery, Sang-Gye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. scd25@paik.ac.kr

상완골 간부 골절에서 교합성 골수강 내 금속정 고정 후 잔존한 골절편 전위에 대한 임상적, 방사선학적 추시

염재광·임동주·정의엽·손수인

인제대학교 의과대학 상계백병원 정형외과학교실

Abstract

PURPOSE
This study is designed to evaluate the clinical and radiographical results for the displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures. MATERIALS AND METHODS: We retrospectively reviewed the results of 8 cases of humeral shaft fractures that have displacements of over 10 mm and under 20 mm after interlocking intramedullary nailing between July 2004 and August 2011. The mean age was 54.1 years (range, 43 to 70 years) and there were 3 male and 5 female patients. Radiographically, the time to bony union, change of displacement and angulation of the fracture site, and degree of improvement of these two factors were measured. Clinically, the range of motion of shoulder and elbow joints, postoperative pain and complications were evaluated.
RESULTS
All cases showed complete bony union in last follow-up. The mean time to bony union was 16.1 weeks. At the last follow-up, almost all cases had normal range of motion of shoulder and elbow joints. But, one case had stiffness of shoulder joint. Therefore, arthroscopic capsular release and manipulation was performed. One case had transient shoulder pain and the other case had transient elbow pain. In the two cases, pull-out of proximal interlocking screw were noted, but they finally had bony union.
CONCLUSION
Although considerable displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures was present, we had excellent radiographical and clinical outcomes. Therefore, an additional procedure, such as open reduction or another fixation for the fracture site, was not necessary.

Key Words: Humerus; Shaft fracture; Interlocking intramedullary nail; Displacement of fracture