Locked intramedullary nailng of the humerus; experience with the Seldel nail

Abstract

Between January 1990 and September 1993, 15 patients with 8 fractures of the humeral shaft and 7 dispIaced fractures of the proximal humerus were treated with Seidel s Iocking nail system. The system advocated by Neer and AO were used to classify the fractures. The humeral shaft fractures consisted of 2 spiral and multifragmentary fractures, 2 nonunions and one distal fractures. The displaced proximal humeral fractures could be classified in 4 two-part and 3 three or four part fractures. The average age at operation was 49 (min. 20, max. 65) years. The follow-up ranged up to 18 (min. 4, max. 30) months. The clinical and radioraphic results of patients treated by Seidel nail were reviewed. The clinical results were assessed using Neer s protocol. At the follow-up examination 5 patients reported persisting shoulder disablity. The overall results were good with no cases of pseudarthrosis, infection or radial nerve palsy. AlI the patients regained full shoulder movements with no evidence of rotator cuff Iesions. According to a clinical rating, 6 (40%) patients had an excellent, 5 (33%) good, 4 (27%) fair, while no poor results was seen. A very reliable and succesfull technique in the treatment of diaphyseal and displaced fractures of the proximal humerus.

Özet

Ocak 1990 ile Eylül1993 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji AnabiIim Dalı na başvuran yaş ortalaması 49 (min. 20, mak. 65) olan 7 humerus üst uç (1. Grup) ve 8 cisim kırıklı (2. Grup), 15 (9 bayan, 6 erkek) olgu kilitli intramedüller Seidel çivisi ile tedavi edildi. Humerus üst uç kırıklı olgularda Neer sınıflandırmasına göre kırık dağıltmı 1 (% 14) Tip 2a, 4 (%57) Tip 3a, 2 (0/028) Tip 2b; cisim kınklt olgularda AO sınıflandırmasına göre kırık dağılımı 2 (%25) AI, 2 (%25) A3, 1 (%12.5) BI, 2 (%25) B2, 1 (% 12.5) CI olmuştur. Ortalama 16 (min. 5, mak. 48) ay izlenen olgularda radyolojik kırık iyileşmesi, fonksiyonel olarak omuz ve dirsek hareket genişliği değerlendirildi. Humerus üst uç kırıklı olguların tümünde, cisim kırıklı olguların 6 (%86) sında tam kırık iyileşmesi elde edildi. Neer skoruna göre 1. Grupta; 3 (%43) çokiyi, 2 (%29) iyi, 2. Grupta 3 (%38) çokiyi, 3 (%38) iyi sonuç alındı.