The purpose of this study was to evaluate the results of interlocking intramedullary nailing for surgical neck fractures of the humerus. We used the ACE humeral nail system which others the advantage of transfixing locking screws for reliable fixation.
From 1997 to 1999, 7 consecutive displaced 2-part surgical neck fractures of the humerus were antegrade nailed with the ACE humeral nail system. The average age of the patients was 61.9 years (range 43 to 80). There were 2 males and 5 females and the average follow-up period was 12.9 months (range 5 to 29). All shoulders were assessed retrospectively and scored using the JOA shoulder scoring system.
All fractures achieved union and there was no delayed union, but one shoulder showed severe varus deformity radiographically. The average JOA score at final follow-up was 85.5 (range 75.5 to 95). The shoulders had an average active flexion of 130 degrees active abduction of, 131 degrees active external rotation of 55 degrees and internal rotation to the 9th thoracic vertebra. Due to technical errors, one patient had subacromial impingement caused by the protrusion of the proximal nail tin.
The operative method reported here otters the advantages of enabling sufficient fixation for osteoporotic cases. It is a useful alternative for the treatment of displaced surgical neck fractures of the humerus.
