Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Shoulder
Abstract number: 25974
DISPLACED 3-PART PROXIMAL HUMERAL FRACTURES TREATED WITH
RETROGRADE HALDER HUMERAL NAIL.
Anish KADAKIA, Ben BROOKE, Subhash C HALDER
Calderdale and Huddersfield NHS Trust, Halifax (UNITED KINGDOM)
Displaced 3-part fractures of proximal humerus are unstable and difficult to fix.
Different methods of operative treatment are available.The aim of this study was to
analyse our results in this group treated by retrograde nailing +/- cannulated screws
for greater tuberosity fixation.Since January 1995, 107 patients with displaced 3-part
proximal humerus fractures were treated with retrograde Halder humeral nail. 81
patients had additional proximal screw(s) fixation. M:F was 15:62. Average age: 67
years. Average follow-up was one year. Displaced greater tuberosity was reduced
with stab incision and fixed with cannulated screws.Proximal rotational stability is
maintained by unique 'Trio Wire'. Distal rotational stability is maintained by transverse
plate, welded on distal end of nail.Postoperatively, all patients were allowed early
active and active-assisted shoulder abduction and forward flexion up to 60degrees.
Shoulder rotation was avoided for 6 weeks. The pain was relieved in almost all
patients within a week. Average time to clinical and radiological union was 6 weeks.
In 80% of patients, painless return to activities of daily living was seen by 10
weeks.In 87 patients fractures united well. 15 patients had malunion, 3 had head
collapse, 2 had AVN humeral head.There was no infection or fracture. There was
average loss of elbow extension of 10-15 degrees.In our experience, displaced 3-part
proximal humeral fractures can be treated with this nail, which avoids major
exposure around shoulder. Compared to other open procedures very minimal
exposure was required to fix greater tuberosity.
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