PURPOSE To assess the effectiveness of optimal treatment of proximal humeral fractures and humeral shaft fractures in elderly patients with osteoporosis using the Polarus nail. MATERIALS AND METHODS Twenty-three patients with proximal humeral and humeral shaft fractures in elderly osteoporosis patients were treated using the Polarus intramedullary nail. Nine patients had proximal humeral fracture, 10 had humeral shaft fracture and 4 had the proximal humeral frac-ture extended diaphyseally. Radiological outcomes included the bone-union and the degree of re-sidual deformity. The residual deformities of the proximal humerus were assessed by the neck-shaft angle and the shaft angulation. Clinical outcome was assessed with the American Shoulder and Elbow Surgeons (ASES) score. RESULTS All cases had bony union and the mean union period was 16.5 weeks. The average neck/shaft alignment at the time of bone union was 135degrees and varus deformities of neck-shaft angle was not seen in all patients. Varus shaft angulation was seen in 5 patients. The mean ASES score after surgery was 86.7 points. CONCLUSION The Polarus intramedullary nail is effective for the treatment of proximal humeral and humeral shaft fractures in elderly patients with osteoporosis because it not only enables early postoperative mobilization, but also obtains bone-union without avascular necrosis and nonunion.
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Surgical Management of Osteoporotic Fractures: Humerus Shaft Fractures Shankar Ramaprasad Kurpad Indian Journal of Orthopaedics.2025;[Epub] CrossRef
PURPOSE To evaluate the radiographic and clinical outcomes of patients with displaced proximal humerus fractures (two-part and three-part) treated with the Polarus interlocking nail, comparing their fractures types. MATERIALS AND METHODS There were 22 patients with displaced proximal humerus fractures. There were 10 surgical neck (SN) and 1 anatomical neck (AN) two-part fractures and 10 greater tuberosity/surgical neck (GT/SN) and 1 GT/AN three-part fractures. All patients were surgically treated solely with the Polarus interlocking nail using a closed technique. Functional assessment was obtained using the American Shoulder and Elbow Surgeons (ASES) score, which grade outcomes as excellent (>75), satisfactory (50~75), poor (<50) results. Radiographic outcome measurements included fracture alignment (neck-shaft angle), loosening of screw, fixation and hardware failure, and malunion and nonunion. RESULTS Overall, the average ASES score was 80.2 (range 46.0 to 98.0). There were 15/22 (68.2%) excellent, 6/22 (27.3%) satisfactory, and 1/22 (4.5%) poor results. All shoulders healed radiographically without evidence of avascular necrosis of the humeral head. When comparing patients with two-part fractures (n=11) with patients having three-part fractures (n=11), there were statistically significant differences with ASES outcome measures (p<0.05). But, there were no statistically significant differences in age-related analysis (p>0.05). CONCLUSION Both displaced two-part fractures and three-part GT/SN fractures can have above satisfactory functional and radiographic outcomes with the Polarus interlocking nail using a closed technique. Even though displaced three-part GT/SN fractures in elderly osteopenic patients (>60 years), we treated successfully with the Polarus interlocking nail.
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Polarus Intramedullary Nail for Proximal Humeral and Humeral Shaft Fractures in Elderly Patients with Osteoporosis Youn-Soo Hwang, Kwang-Yeol Kim, Hyung-Chun Kim, Su-Han Ahn, Dong-Eun Lee Journal of the Korean Fracture Society.2013; 26(1): 14. CrossRef
Intramedullary Nailing for Complex Fractures of the Proximal and Midshaft of the Humerus Chul-Hyun Cho, Gu-Hee Jung, Kyo-Wook Kim Journal of the Korean Fracture Society.2011; 24(3): 237. CrossRef