Abstract
Aims: Most diaphyseal humeral fractures must be treated conservatively. Surgery is indicated for transverse displaced fractures, pathological or impending fractures, non unions, fractures with radial nerve palsy and oblique fractures after conservative treatment failure. Methods: Between March 1998 and July 2001 we operated on 80 patients with a diaphyseal humeral fracture. The cannulated retrograde EXP nail (LIMA LTO) was always employed. Proximal locking is obtained through the nail by causing angled protrusion of a wire from the proximal end of it and into the spongious (cancellous) bone of the humeral head. Distally the EXP nail has two little wings shaped to sit on the medial and lateral columns of the olecranic fossa and to thus provide a very effective rotational and traction control. In 51 cases it was a traumatic fracture; transverse, oblique unstable or polytrauma. In 10 cases a pathological fractures, in 7 an impending fracture, in 12 a nonunion. Nonunion cases had had a previous average of 2.5 operations. 10 patients were obese. Results: Average surgical time was 40 minutes. Average radiation exposure was 1 minute and 40 seconds. Union was obtained in all the 51 primary fractures and stability was secured for all the impending and pathological cases. All but 1 of the non-unions healed after an average of 2.6 months. The one failure was in an obese 65 yrs old lady with an oblique unstable non-union. No patients suffered shoulder pain. In 4 cases a reduction of less than 10 degrees of elbow extension was detected. Conclusions: The EXP humeral nail provides satisfactory stability, it is cannulated and requires minimal radiation exposure.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
