Treatment of fractures of the proximal end and humeral shaft by locked intramedullary nailing in adults: Case series and literature review

Introduction: Intramedullary nailing is a good indication for stabilizing displaced fractures of the proximal end and shaft of the humerus in adults. Methods: This was a prospective series of 24 patient, over a period of 9 months. The aim of this study is to report the epidemiological and clinical aspects of patients treated with a locked humeral nail and to show the medium-term interest, of this therapeutic method, thus discussing the complications. Results: All patients had received intramedullary nailing of the humerus. The average age was 77.08 years. The female sex was more represented with 66.66% and the right side was frequently fractured with 83.33%. We distinguished 50% of cases involving the proximal end of the humerus, 45.87% of cases of the humeral shaft and one case of concomitant fracture of the proximal end and that of the humeral shaft. The postoperative infection rate is zero in our series and we reported 1 case of distal locking screw breakage, 1 case of iterative fracture on short Telegraph nail, 1 case of proximal screw retraction on long Telegraph nail and 1 case of perforation of the humeral head with a proximal locking screw. Conclusion: humeral intramedullary nailing is a good alternative in fixing proximal end and humeral shaft fractures without considerable complications or damages for the rotator cuff muscles.