ANTEGRADE INTRAMEDULLARY FIXATION OF HUMERAL SHAFT FRACTURES WITH INTERLOCKING NAIL - AN ANALYSIS OF COMPLICATIONS

Fractures of the humeral shaft account for 3% of all the fractures. Primary cause of these fractures is high energy traumas. Goals in managing these fractures are osseous union, minimal deformity and return of maximal extremity function. The union rate of simple fractures of humerus treated conservatively is over 90%. Surgical management of these fractures is preferred in Segmental fractures, Polytrauma patients, Pathological fractures, Open fractures, Failed conservative treatment, Associated progressive neurological deficit, Vascular injury, Morbid obesity. We analysed intraoperative and postoperative complications in twelve patients with humeral shaft fractures managed with antegrade interlocking nails. There were seven males and five females. Their ages ranged between 20 - 60 years with an average of 32.6 years. There were 11 close and one Gustilo grade I open fractures. There were six comminuted, four transverse, and two oblique fractures. Nine fractures were in middle third one in proximal third and two in distal third. Five patients had associated injuries. We faced difficulty in localizing entry portal in 2 patients. There was difficulty in reduction in 2 patients We had one patient with iatrogenic comminution. Three patients had improper locking screw size. One had nail protrusion proximally, one patient had distraction at the fracture site. There were two superficial entry portal skin infections and one deep proximal cross screw infection. We had two patients with shoulder and one patient with elbow stiffness. Chronic rotator cuff irritation was present in three patients. We recorded three delayed unions, one nonunion and one rotatory malunion The results of the present study indicate that antegrade intramedullary interlocked nailing is one of the best method of treatment among the currently available methods. INTRODUCTION: Fractures of the humeral shaft account for 3%5of all the fractures. Primary causes of these fractures are RTA, falls from height or other high energy traumas. The primary goals in managing these fractures are osseous union, minimal deformity and return of maximal extremity function. The union rate of simple fractures of humerus treated conservatively is over 90% 27. Open reduction and internal fixation of these fractures is preferred in segmental fractures, polytrauma patients, pathological fractures, open fractures, failed conservative treatment, associated progressive neurological deficit, vascular injury, morbid obesity 6 . Among the various surgical methods for management of humeral shaft fractures is the intramedullary fixation with interlocking nail.