Rotational alignment of humerus after closed locked nailing

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Radiology

Background:

• Rotational malalignment is a potential complication of closed nailing for humeral fractures.
• The influence of surgical arm positioning on rotational alignment remains under-investigated.

Purpose of the Study:

• To assess the effect of arm position during closed nailing on humeral rotational alignment.
• To evaluate the impact of this rotational alignment on shoulder motion and function.

Main Methods:

• Retrospective study of 30 patients undergoing closed humeral locked nailing (15 antegrade, 15 retrograde).
• Computed tomography (CT) scans measured humeral retroversion angles.
• Shoulder range of motion and Neer scores were assessed for fractured and intact humeri.

Main Results:

• Significant differences in humeral retroversion and external shoulder rotation were observed between antegrade and retrograde nailing in the decubitus position.
• No significant differences in internal rotation or Neer scores were found between these groups.
• No significant difference in humeral retroversion discrepancy was noted between antegrade nailing and retrograde nailing in the supine resting position.

Conclusions:

• Surgical arm positioning can significantly alter humeral rotational alignment and shoulder range of motion during closed nailing.
• The study recommends employing the resting arm position for closed nailing of humeral shaft fractures due to its favorable alignment outcomes.