Treatment of Proximal Humeral Fractures by Angular Stabile, Antegrade, Interlocking Intramedullar Nail
Abstract
INTRODUCTION: The objective of our study is evaluation of clinical and radiological results of dislocated proximal humeral fractures, treated by direct, angular stabile, antegrade and interlocking implants Targon PH (Aesculap, Tuttlingen, Germany). METHODS: We evaluated 102 patients (76 female and 26 male), average age was 67.3 years (26-87 years).
The standard nail was used in 73 cases; the long one was used in 29 cases. We interpreted functional results (Constant's score and relative Constant's score), radiological results and postoperative complications.
RESULTS: Constant's score achieved average 51.3 points--3 weeks after operation, 67.4 points--after 6 months and 75.8 points--after 1 year. Value of the relative Constant's score was 59.3%, 75.9% and 83.5%.
We have found trend to the poorer functional outcomes in all complicated four-part fractures; especially in cases with disarticulation. The complete bone healing was reached in: 63.7% up to 3 months, 95.1% up to 6 months and 99% up to 1 year.
We detected lecase of the pseudoarthrosis. We had 37 complications in our 102 patients group in the first year after operation.
The migration of the proximal fixation screws was most frequent complication--12 patients. Eight times the humeral head aseptic necrosis appeared (5x partial, 3x complete), 3 times redislocation of tuberculum maius was found.
We made reoperation 2 times by Phillos plate (1x for pseudoarthrosis, 1x for broken screws). CONCLUSIONS: Targon PH is intramedullary nail stabilisation of proximal humeral fractures by angular stabile, antegrade, interlocking system.
We consider it for mini-invasive technique that provides high stability in osteoporotic bone and allows immediate postoperative shoulder mobilisation.