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Aim of study: To demonstrate clinical and radiological effectiveness of intramedullary fixation of closed diaphyseal humeral fractures in adults using the elastic stable intramedullary nail (ESIN). Patients and methods: Between May 2011 and December 2013, twenty-eight patients (19 males) with closed diaphyseal humeral fractures treated with closed...
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Thrower’s fractures are Spiral fractures of the humerus in the ball. They represent very uncommon clinical entities that can simulate pathologic fractures. Moreover, the concomitant neurologic deficient is rare. Herein we report a 27 years old muscular man presented a spiral fracture of the humerus following a forceful throw of the ball during an a...
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... The use of EIN only for proximal humerus fracture was also an exclusion criterium. We ended up with seven studies that fulfill our criteria ( [15,16,20]. Nail impingement and elbow stiffness six months post-operatively, were present only in five patients in total, and they were the result of improper surgical technique and rehabilitation. ...
... [14][15][16][17][18][19][20]. ...
A polytrauma patient with a life-threatening condition is a quite demanding situation due to special considerations regarding the time, the way, and the sequence of the necessary procedures. Elastic intramedullary nails (EIN) could be used under these conditions for adult patients with humeral fractures requiring fixation. Here we present a case of a multi-segmental closed humerus fracture in a polytrauma patient treated by EIN. The general condition of the patient and the need for multiple surgical procedures required the selection of a minimally invasive and time-saving fixation technique. The patient's follow-up was uneventful with complete healing of the humeral fracture; the functional scores results are excellent at five years post operatively. A review of the literature revealed limited published cases of humeral fractures (128 patients) treated by EIN, despite the fact that the results are quite encouraging. Based on our results and the current literature, we believe that EIN could become an effective treatment choice for multi-level humerus fractures, especially in damage control surgery.
... Kornah AB et al. reviewed surgically managed 28 closed humeral diaphyseal fractures using ESNF showed excellent, good, fair and poor in 17, 8, 2, 1 case respectively according to DASH score. They concluded for treating adult humeral shaft fractures holds good with elastic nailing system [11]. Zivanovic VD et al. retrospectively reviewed 32 patients with humeral shaft fractures managed with ESNF and concluded ESIN as the surgical method of choice for displaced humeral fractures in children and adolescents without any significant complications [12]. ...
Background: Children are at a high risk of injury with up to one of every four children sustaining an injury annually. A positive approach to patient care by the treating Orthopaedic surgeon should be done to improve the functional quality of patient’s life. Due to the evolution of surgical implants, there is a paradigm shift over to internal fixation and early mobilization, with a return to normal function as early as possible. Objectives: To prospectively review the efficacy, the functional outcome and the complications of TENS nailing in pediatric diaphyseal long bone fractures. Materials and Methods: After the screening of patients, a total of 229 cases, which were enrolled in the study, were subjected for surgical management with TENS nailing. All the patients were followed up clinically and radiologically at the immediate post-op period and at the end of 1, 3, 6, 12 and 18 months. The efficacy and functional outcome of TENS nailing were charted according to DASH, Mayo’s wrist, Harris Hip score, and Lysholm scores. The ranges of movements were documented with Flynn’s criteria. All patients were offered with surgical implant removal at an average of 18 months post-surgical procedure that showed fracture union. Results: Out of 229 cases, 140 cases were males and 89 cases were females with fall while playing followed by fall from a height being the most common mode of injury. The pattern of fractures was transverse in 109 cases, spiral in 53 cases, and oblique in 31 cases and comminute in 36 cases. All cases showed the union of fracture with an average of 13.37 ± 1.35 weeks. The functional range of movements (n=229) according to Flynn’s criteria were excellent in 179 cases, good in 37 cases and poor in 13 cases. The most common complication encountered in this study was pain, superficial infection at the nail insertion site, followed by malunion, non union, nail migration, and malalignment. Implant removal was done under loco-regional anesthesia in an average of 17.32 ± 3.49 months. Conclusion: TENS is the ideal device for the treatment of pediatric diaphyseal long bone fractures, which is a load sharing internal splint that allows mobilization and maintenance of alignment and extremity length until bridging callus forms.
... None of the patients experienced implant failure. [24] The recent prospective study by Patel et al. and the retrospective study by Upadhyay and Lil both used an antegrade approach and exclude unstable fracture geometry. Only two cases out of the 25 in Upadhyay and Lil study revealed nail impingement at the proximal end. ...
Despite the success of nonoperative treatment in the majority of adult‑comminuted proximal third humeral shaft fractures, surgical intervention is preferable in selected cases in order to avoid specific potential disadvantages associated with nonoperative treatment, including shoulder and
elbow stiffness, poor compliance, and nonunion. Elastic stable intramedullary nailing (ESIN) is commonly used in the treatment of children’s
long‑bone fractures and is known to achieve a high union rate with minimal complications. The literature review of the use of percutaneous
ESIN treatment of comminuted proximal third humeral shaft fractures reveals that while it is not a common procedure, it can still produce
favorable results with limited complications. This paper evaluates the use of ESIN in two patients with comminuted proximal third humeral
shaft fractures. The patients were aged 56 and 72 and both had experienced comminuted proximal third humeral shaft fractures. In this report,
the management of these cases is presented, along with a review of other studies, which used ESIN in the treatment of humeral shaft fractures
in adults.
