Interlocking nailing of humeral shaft fractures: the Oxford experience 1991 to 1994

Forty-three patients with fractures of the humeral shaft were treated by locked intermedullary nailing, using the Russell-Taylor nailing system. Overall there were few technical problems with nail insertion. Additional fracture comminution occurred in five patients but affected stability in only one case. Twenty-six nails were inserted into 22 patients with pathological fractures. The objective of fracture stabilization and pain relief for the remaining life-span of the patient was achieved in all but one case. Out of 21 non-pathological fractures, seven had failed to unite at 8 months (33 per cent). Furthermore, five of the 17 fractures nailed soon after injury (29 per cent) went on to non-union. Four of 15 patients reviewed clinically had poor or unsatisfactory shoulder function. These results suggest that interlocking nailing should be used with caution in the management of non-pathological fractures.