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THE USE OF THE POLARUS NAIL IN THE TREATMENT OF THREE-AND FOURPART FRACTURES OF THE PROXIMAL HUMERUS



Abstract

Three and four part fractures of the proximal humerus can prove difficult to treat and results are generally poor. We used a Polarus Nail technique to treat seven consecutive patients who had sustained an isolated fracture to the proximal humerus. According to Neers classification, four patients had sustained a three-part fracture and three patients a four-part fracture. One patient had a fracture dislocation.

At review, six of the seven patients were assessed using the Constant and Dash scoring systems. One patient had died, but at last review had been discharged with a satisfactory result.

The average age of the patients reviewed was 62 years (range 48–79). The dominant hand was affected in 2 patients.

All six patients were followed up to fracture union and were happy with the result of treatment. All patients had mild or no pain. The average Constant score was 83 (range 59–98) and average Dash score was 131 (range 8–300)

When comparing our results to other methods of treatment already described, we found that fixation using a Polarus nail provided a satisfactory alternative method. In fact, our patients appeared to have less pain and a higher score to all elements of the Constant score.

We conclude therefore that the use of the Polarus Nail should be considered as a treatment option in this group of patients.

The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN