RT Journal
A1 Hatzidakis, Armodios M.
A1 Shevlin, Michael J.
A1 Fenton, Duane L.
A1 Curran-Everett, Douglas
A1 Nowinski, Robert J.
A1 Fehringer, Edward V.
T1 Angular-Stable Locked Intramedullary Nailing of Two-Part Surgical Neck Fractures of the Proximal Part of the HumerusA Multicenter Retrospective Observational Study
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD December 7
VO 93
IS 23
SP 2172
OP 2179
DO 10.2106/JBJS.J.00754
UL http://dx.doi.org/10.2106/JBJS.J.00754
AB Background: 
  The ideal fixation technique for the treatment of proximal humeral fractures remains unclear. In the present study, we evaluated the experience of three surgeons with the treatment of two-part surgical neck fractures with angular-stable intramedullary fixation.Methods: 
  Forty-eight patients with forty-eight Neer two-part surgical neck proximal humeral fractures were managed with locked angular-stable intramedullary nail fixation by three surgeons. Shoulder pain and outcomes were quantified with Constant scores and standard radiographs.Results: 
  Thirty-eight patients (including twenty-eight female patients and ten male patients) with a mean age of sixty-five years were followed for at least twelve months (mean, twenty months; range, twelve to thirty-six months). All fractures healed primarily. The mean follow-up Constant score (and standard deviation) was 71 ± 12 points (range, 37 to 88 points), with a mean age-adjusted Constant score of 97% (range, 58% to 119%). The mean Constant pain score was 13 ± 2.2 (possible range, 0 to 15 points, with 15 points representing no pain). The mean forward flexion was 132° ± 22°. All fractures but one healed with a neck-shaft angle of ≥125°.Conclusions: 
  Patients who were managed with locked angular-stable intramedullary nailing of two-part surgical neck proximal humeral fractures via an articular entry point had reliable fracture-healing, favorable clinical outcomes, and little residual shoulder pain.Level of Evidence: 
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.