During the last decade intramedullary nailing of the humerus became a more popular operation. Modern nails are successfully used in treatment of fractures involving proximal, distal and middle shaft humerus, as well as pseudarthrosis and pathological fractures. Minimal invasive insertion lessens the complications from neurovascular and soft tissue damage without significant delay in healing period in comparison with compression plates. Aim of our study is to present our experience and the clinical outcomes of this method.

Material and Methods: Between 1998 and 2006 50 patients (52 Fractured Hunerus) were treated in our department. The mean average age was 35 y.o. (18–55 y.o.) and the operation time was 2.5 days after the injury. All fractures were acute (Unstable, comminuted, in both limps or polytrauma patients). In 25 cases we used the unreamed Synthes nail (22 Cases Antegrade insertion and 13 Cases retrograde insertion). In 27 cases we used the T2 or Polarus reamed nail (23 cases Antegrade insertion and 4 cases retrograde insertion). The mean duration of the surgery was 1.3 h.

Results: The healing time was 12.5 weeks (8–16) and no preudarthrosis occurred. There were 4 radial nerve palsies (2 primary – 2 after operation) that were neuroapraxia and resolved in almost 6 weeks. One antegrade nail (Polarus-reamed) was malpositioned and applicated again and in 2 retrograde nails the posterior cortex of the fossa was fractured (in one case we changed fixation method-plates). No infection occurred. In some patients full abduction, elevation and external rotation achieved in 6 weeks and in some others after 3 months.

Conclusions: Intramedullary nailing of the humerus is a very good solution of fracture treatment, especially in multiple trauma patients. In good hands offers good fracture alignment and adequate stability. Postoperative rehabilitation period is short, uneventful healing is common and almost excellent results always appear.

Aims: The purpose of this study is to examine the rate of pseudarthrosis and possible factors involving the healing of the fracture after interlocking nailing (ILMN) as treatment of femoral shaft fractures. We examined the type of the fractures, surgical pitfalls, complications, if the patients smoked cigarettes or tooled other medications and drugs. Methods: Between 1996–2001 we treated 165 patients who had 180 fractures of the femur shaft. In 4 out of our patients primary have treated using interlocking intramedullary nailing we occurred pseud-arthrosis. We have use AO nail in 3 patients and R-T nail in one patient. After the removal of primary nailing þxation components all patients treated with ILMN wider nail and autogenous bone grafting. The preferred method of stabilization is reamed interlocking intra-medullary nailing using AO Nail. Results: Radiological callus formation was apparent in all patients after a period of 18 to 26 weeks (average time 20w). Serious complications were not observed Stiffness of the knee joint was noted in one and pain in distal metaphysis in two cases. Conclusions: The sort-term results have been more than encouraging. We recommend the reaming technique and the dynamization of the nail for optimal outcome. Bone grafting is necessary according to our opinion. Several factors involved the healing of the femoral shaft fracture, after interlocking intramedullary nailing as primary treatment.