Ki-Bum Choi; Soo-Hwan Kang; Yoon-Min Lee; Seok-Whan Song; Youn-Jun Kim

doi:10.12671/jkfs.2013.26.4.299

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Original Article
Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail: Ki-Bum Choi, M.D., Soo-Hwan Kang, M.D., Ph.D., Yoon-Min Lee, M.D., Seok-Whan Song, M.D., Ph.D., Youn-Jun Kim, M.D.; Journal of the Korean Fracture Society 2013;26(4):299-304.
DOI: https://doi.org/10.12671/jkfs.2013.26.4.299
Published online: October 18, 2013

Department of Orthopedic Surgery, The Catholic University of Korea Yeouido St. Mary's Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, The Catholic University of Korea St. Paul's Hospital, Seoul, Korea.

Address reprint requests to: Seok-Whan Song, M.D., Ph.D. Department of Orthopedic Surgery, The Catholic University of Korea Yeouido St. Mary's Hospital, 10 63-ro, Yeongdeungpo-gu, Seoul 150-713, Korea. Tel: 82-2-3779-1192, Fax: 82-2-783-0252, sw.song@catholic.ac.kr

• Received: December 27, 2012 • Revised: July 16, 2013 • Accepted: August 22, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to report the outcome of treatment of humeral shaft fracture with retrograde intramedullary nail of advanced insertion opening.
Materials and Methods
From April 2005 and August 2012, 22 patients with a humeral shaft fracture were treated by a single surgeon using the technique of retrograde intramedullary nail at Department of Orthopedic Surgery, Yeouido St. Mary's Hospital (Seoul, Korea). To avoid causing fractures at the insertion site, the entry point was more distally located than conventionally, and was extended proximally to include the proximal marginal cortex of the olecranon fossa. The outcome was evaluated clinically and radiologically.
Results
The mean period of achievement of bony was 5.8 months (4-11 months). Additional fixations were needed in one patient with intraoperative lateral condylar fracture and 2 patients with postoperative nonunion. There were no limitations of movement or pain in the shoulder joint, and 8 cases had a 6.5° flexion contracture on average.
Conclusion
This retrograde intramedullary fixation technique using a distal entry portal near the olecranon fossa is particularly useful in humeral shaft fractures without a neurovascular injury. The risk of an intraoperative fracture (supracondylar fracture or fracture around the entry portal) can be decreased using this treatment. We recommend this technique because of the safety and the satisfactory outcome.
Key words: Humeral shaft, Fracture, Retrograde, Intramedullar fracture fixation

REFERENCES

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Fig. 1

(A) The skin was incised curvilinearly from the midline of the distal humerus to the lateral condyle.

(B) After using the triceps splitting approach, (C) a cortical window was made at the superior margin of the olecranon fossa and was extended proximally about 3 cm.

(D) Nail and locking screws were inserted, without an iatrogenic supracondylar fracture occurring.

Fig. 2

(A) Initial radiographs show a short oblique fracture of the humeral shaft area.

(B) After fixation by a retrograde intramedullar nail, the fracture site was reduced, with a minimal gap.

(C) At postoperative 5 months, the fracture site was completely united.

Table 1

Summary of Cases

M: Male, F: Female, TA: Traffic accident, F/U: Follow up.

Figure & Data

REFERENCES

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HEALING PATTERN OF INTERLOCKED INTRAMEDULLARY NAILED HUMERAL SHAFT FRACTURE
Myung-Sang Moon, Dong-Hyeon Kim, Min-Geun Yoon, Sang-Yup Lee
Journal of Musculoskeletal Research.2016; 19(04): 1650018. CrossRef

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Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail

J Korean Fract Soc. 2013;26(4):299-304. Published online October 31, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.4.299

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Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail

Fig. 1 (A) The skin was incised curvilinearly from the midline of the distal humerus to the lateral condyle. (B) After using the triceps splitting approach, (C) a cortical window was made at the superior margin of the olecranon fossa and was extended proximally about 3 cm. (D) Nail and locking screws were inserted, without an iatrogenic supracondylar fracture occurring.

Fig. 2 (A) Initial radiographs show a short oblique fracture of the humeral shaft area. (B) After fixation by a retrograde intramedullar nail, the fracture site was reduced, with a minimal gap. (C) At postoperative 5 months, the fracture site was completely united.

Fig. 1

Fig. 2

Treatment of Humeral Shaft Fracture with Retrograde Intramedullary Nail

Table 1

Summary of Cases

M: Male, F: Female, TA: Traffic accident, F/U: Follow up.

Table 1 Summary of Cases

M: Male, F: Female, TA: Traffic accident, F/U: Follow up.