[Long-term results of nailing of extra-articular proximal humerus fractures]

PURPOSE OF THE STUDY To evaluate the long-term results of intramedullary nailing of extra-articular proximal humerus fractures. MATERIAL AND METHODS Thirty-six patients with 36 extra-articular fractures, types 11-A2 and 11-A3, treated by intramedullary nailing were reassessed after an average follow-up of 54 (30-86) months. The group included five type 11-A2 and 31 type 11-A3 fractures according to the AO/OTA classification. Radiographic and clinical outcomes - the absolute Constant score (CSabs) and the relative Constant score (compared to the contralateral side, CSrel) were evaluated. The rate of complications was assessed. RESULTS All fractures healed. The mean long-term CSabs was 73 pts, the mean CSrel was 89% of the unaffected side. Thirty (83%) patients achieved excellent or good results (CSrel higher than 80%), four (11%) had satisfactory and two patients (5.5%) had poor results (CSrel less than 60%). No significant difference was observed in functional results between different age groups. No non-union, loss of reduction or deep infection was encountered. Two cases of prolonged healing were observed, one implant-related complication happened due to locking screw breakage. Conclusion Nailing can be recommended for the safe treatment of extra-articular fractures of the proximal humerus. If the procedure is performed properly, the possibility of excellent functional results is high and the rate of complications is minimal. Age does not influence the final functional result. Key words: proximal humerus, extra-articular fractures, intramedullary nail, long-term results.