Abstract
Objectives: To assess the stabilizing effect of Ender nails on humeral shaft fracture and to assess proper nail length.
Materials and Method: Ender nailing was performed in 67 patients. Age ranged from 22 to 79 years. 9 were open fractures, and the 58 were closed ones; 13 comminuted, 28 spiral, 23 transverse, and 3 segmental fractures. 19 had associated injuries in other parts. One nail was used in 18 cases, two nails in 46 cases, and three nails in 3 cases. In 16 cases long nails were used. In the 12 elderly patients nail was inserted under local anesthesia, In all cases the sling and swathe was applied postoperatively to avoid rotatory shear.
Results: Radiologically visible bridging callus was observed at 6.8 weeks on average: the earlist one was at postop 5 weeks, and the latest was at postop 15 weeks. The average clinical union time was 9.3 weeks. In the 6 cases the long nail distracted the fracture gap, and resulted in delayed union. In the 10 remainders the distracted gap was spontaneously reduced when the nails migrated proximally through an entry hole. In cases of proximal nail migration, shoulder pain and partial stiffness were complicated, which disappeared after nail removal.
Conclusion: It is found that intramedullary Ender nailing is a simple and less invasive surgical procedure in humerus which brings the successful fracture union with least complications.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
