A Comparative Study on Internal Fixation Using Long Proximal Intramedullary Nail for the Treatment of Humeral Shaft Fracture according to Fracture Types.

Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types.

Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20-87 years), and mean follow-up period was 2.3 years (range, 1.0-6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed.

Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (<0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (=0.352).

Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.