Treatment of Proximal Humerus Fractures with the Stryker T2 Proximal Humeral Nail: A Study of 61 Cases

Background Surgical treatment of displaced proximal humerus fractures remains controversial. There is little guidance on which patients are likely to do well with humeral nailing. Therefore we present our study evaluating the Stryker T2 proximal humeral nail (T2-PHN). Methods Sixty-one consecutive patients with acute unilateral displaced proximal humerus fractures were treated with the T2-PHN and followed up for a mean of 19 months. There were 46 females and 15 males with mean age 68 (range 36–97). By Neer's classification there were 25 two-part, 28 three-part and 8 four-part fractures. Results Union occurred at a mean of 3 months. Fifty-five patients had Constant-Murley scores with a mean score of 64.9. Mean Constant-Murley was 59.9 for over 70s, 69.7 in under 70s, 68.0 in 2-part fractures, 67.5 in 3-part fractures, 36.6 in 4-part fractures, 50.6 in post-operative varus, 73.5 in post-operative neutral, 72.7 in post-operative valgus, 55.5 in medial metaphyseal comminution and 69.5 without comminution. Fifty-four patients had Oxford Shoulder scores with a mean score of 21.7. Conclusions The T2-PHN has a learning curve. Important points include adequate recessing of the nail tip and suturing of tuberosities. The best results can be expected in under 70s, 2 and 3-part fractures, patients without medial metaphyseal comminution and patients with neutral post-operative neck-shaft alignment.