Muthukumar, K (2007) Radiological and Functional Outcome of Retrograde Nailed Humeral Diaphyseal Fracture. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Of all fracture of upper limb, the fracture shaft of humerus is relatively common and easiest to treat. Fracture shaft of humerus accounts for 1% of all adult fractures. There is wide array of good options for their treatment and there is controversy over best methods for many situations. Appropriate decision making for non-operative or operative treatment depends on a thorough understanding of regional anatomy, fracture pattern (Personality of fracture), Classification and finally factors unique to patient (Personality of patient). AIM: To study and analyse radiological union, functional outcome and complications of retrograde unreamed intramedullary interlocking nailing for treating acute humeral diaphyseal fractures in adults. MATERIALS AND METHODS: Our prospective study was from April 2004 to Feb 2006. At our institution, we selected 19 cases of diaphyseal fractures of humerus for this prospective study. All fresh fractures of the humeral shaft chosen for operative treatment including isolated fractures and those in polytrauma patients were nailed in retrograde manner. When there were no clear indications for operative treatment patients were asked for informed consent for retrograde nailing. RESULTS: Out of the 19 patients evaluated, The average hospital stay was 19 days and the mean healing time of a all fractures was 13.74 weeks. Patients with isolated lesions were in hospital for a mean of 14 days. At review, shoulder function was excellent in 17 patients, good in one patient, fair in one patient, no one in poor grade. Elbow function was excellent in 14 patients, good in 3 patients, two in fair grade, no one in poor grade. Total functional out come was excellent in 84% patients, good in 7.8% patients, fair in 6.5% patient poor grade in 1.31% patient. CONCLUSION: The concept of biological fixation in terms of unreamed nailing, closed reduction, static locking and fracture site compression promotes early and adequate fracture union. The problem of shoulder impingement and peri-arthritis shoulder, rotator cuff injury in ante grade nailing are completely avoided with good functional outcome. It helps in providing early rehabilitation and lessens the morbidity. Retrograde humeral nailing is better than anterograde nailing and alternative to plate osteosynthesis for patients with indications for the operative treatment of fractures of the humeral shaft. Retrograde nailing is an attractive option in polytrauma, for isolated fractures which would be difficult to treat conservatively and for patients who require a rapid functional recovery.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Radiological ; functional outcome ; Retrograde Nailed Humeral Diaphyseal Fracture. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Sep 2017 15:14 |
| Last Modified: | 17 Sep 2017 02:51 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2934 |
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