2006, Number 6
Acta Ortop Mex 2006; 20 (6)
Intramedullary nailing of humeral shaft fractures with the Russell Taylor nail. A Review of 14 cases
García JJD, Aguilera ZJM, Encalada DMI, Lozano RS, Peón VH
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ABSTRACTIntroduction. Humeral shaft fractures are common; they represent 3% of all fractures. There are several treatment modalities for this type of fractures. The latest research emphasizes minimum exposure and rigid fixation. Objective. To present the clinical and radiological course of antegrade intramedullary fixation of humeral shaft fractures in a group of patients seen at Medica Sur Hospital. Material and methods. Fourteen male patients with a diagnosis of humeral shaft fracture were retrospectively analyzed. Mean age was 24 years. The Russell Taylor nail was used in all of them with the closed antegrade insertion technique (100%); proximal and distal locking was achieved with only one pin. Mean operative time was 45 minutes. Results. Thirteen patients had closed fractures (92.85%), one patient had an open fracture (7.14%). Mean time to shoulder and elbow mobilization was 48 hours in 12 patients (84%); mean time to resuming activities of daily living without weightbearing was six weeks in 13 patients (91%). Mean time to return to physical/sports activities was 20 weeks in 12 patients (84%). Mean time to grade III-IV X-ray healing was 14 weeks. Complications: delayed healing, 1 patient (7%); postoperative neuropraxia of the radial nerve, 2 patients(14%); painful shoulder, 2 patients (14 percent). Conclusion. Closed locking intramedullary nailing with the Russell Taylor nail warrants overcoming the learning curve to minimize iatrogenic complications. It provides immediate stability resulting from the proximal and distal locking, and allows for rapid patient rehabilitation with full mobility and early stimulation of bone callus formation.