[Interlocking nailing of the humerus]

Within a 3-year period a total of 42 humeral fractures were treated. Nineteen of these were operated on with the Seidel intramullary interlocking nail. Most of the fractures could be classified into group A (AO classification); three type B and four type C fractures occurred. Two patients had pathological fractures due to bone metastases. Mean hospital inpatient treatment was 24 days. Besides two infections seven system-specific complications occurred. A discrepancy between the diameter of the nail and the width of medullary cavity was the reason in one case for an additional fracture and in another case for nonunion because of loosening of the nail tip in the distal fragment. Three further intraoperative fractures occurred during impaction of the nail, the reasons are also device-specific and are carefully analyzed. In two cases we were forced to remove the nail because of subacromial impingement due to an overranging proximal nail end. Finally, a normal intraoperative and postoperative course with good functional results could only be observed in approximately half the cases. Thus, our initial optimism with respect to the outstanding theoretical concept was dampened, so that the interlocking humerus nail is now just applied in pathological shaft fractures.