OTA 2008 Posters

Scientific Poster #123 Upper Extremity OTA-2008

Treatment of Diaphyseal Humeral Fractures with a Unique Interlocking Nail

Oleg Gendin, MD1 (n); Volodya Brukanov, MD2 (n); Robert Schultz, MD2 (n);
1Krasnoyarsk Emergency Hospital, Krasnoyarsk, Russia;
2Billings Clinic, Billings, Montana, USA

Hypothesis: A unique interlocking tibial nail can be used to treat diaphyseal fractures of the humerus successfully.

Methods: The SIGN (Surgical Implant Generation Network) nail, which allows distal interlocking without the use of radiographic imaging, was used from September 2003 to March 2008 to treat 91 humerus fractures. All nails were placed in a standard antegrade approach. All distal interlocks were successful without the use of a C-arm. Open reduction was used in 60% of the cases. A locally developed clinical outcomes instrument was used along with radiographs to determine outcomes.

Results: Patients were followed until radiographic healing, which occurred in all followed cases. Follow-up was finalized on 80% of operated patients. There were no nonunions or malunions. Three radial nerve palsies occurred, all of which resolved without treatment. There were no infections. 80% of patients returned to preinjury activities, with night pain occurring in only 6%. Elbow motion returned to normal in all patients and shoulder motion was limited in four patients. One patient required nail revision due to nail prominence. There were no failures of hardware.

Conclusions: The SIGN nail, originally designed for tibia fractures, can be successfully used to treat humerus fractures. Its unique distal interlocking technique allows the nail to be used without image control. Open reduction does not lead to an increase in nonunions with this nail technique. This is in contrast to previously published series.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.