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Straight IM nails for proximal humeral fractures may yield better outcomes
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While intramedullary nailing is often indicated for older patients displaced proximal humerus fractures, next generation straight humeral nails were associated with fewer complications in patients with these fractures.
A recent study in the Journal of Shoulder and Elbow Surgery included 26 patients with proximal humeral fractures treated with the new MultiLoc straight humeral intramedullary (IM) nail (Synthes; Oberdorf, Switzerland) and another 26 patients treated with the Polarus curvilinear IM nail (Acumed, Hillsboro, Ore.). Investigators performed clinical and radiographic evaluations in both groups at a final follow-up of 14 months average and used the adjusted Constant score to measure clinical outcomes.
The mean Constant score in the curvilinear Polarus nail group was 72.7 points and it was 83.3 points in the MultiLoc straight nail group.
Among patients treated with the straight nail, fewer patients showed symptoms related to rotator cuff disease and the percentage of patients in that group who needed a reoperation was lower than in the curvilinear nail group, based on the study findings.
At final follow-up, Yaiza Lopiz, PhD, MD, and colleagues reported mean neck-shaft angles of 135° in the straight humeral nail group and 130° the curvilinear nail group.
“Straight intramedullary nails had a comparable rate to an accepted curvilinear design, with a much lower incidence of complications,” Lopiz and colleagues wrote.
Reference:
Lopiz Y. J Should Elb Surg. 2014;doi: 10.1016/j.jse.2013.08.023.
Disclosure: The authors have no relevant financial disclosures.