TY - JOUR T1 - Angular-Stable Locked Intramedullary Nailing of Two-Part Surgical Neck Fractures of the Proximal Part of the HumerusA Multicenter Retrospective Observational Study AU - Hatzidakis, Armodios M. AU - Shevlin, Michael J. AU - Fenton, Duane L. AU - Curran-Everett, Douglas AU - Nowinski, Robert J. AU - Fehringer, Edward V. Y1 - 2011/12/07 N1 - 10.2106/JBJS.J.00754 JO - The Journal of Bone & Joint Surgery SP - 2172 EP - 2179 VL - 93 IS - 23 N2 - 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. SN - 0021-9355 M3 - doi: 10.2106/JBJS.J.00754 UR - http://dx.doi.org/10.2106/JBJS.J.00754 ER -