Functional Outcome after Intramedullary Nailing of Humeral Shaft Fractures: Comparison between Retrograde Marchetti-Vicenzi and Unreamed AO Antegrade Nailing

BACKGROUND We compared anesthesia time, complications, fracture healing, as well as shoulder and elbow function after retrograde and antegrade nailing of humeral shaft fractures or impending fractures. METHODS Thirty retrograde Marchetti-Vicenzi nails (MVN) and 22 antegrade locked AO unreamed humeral nails (AO-UHN) were inserted in 52 patients. Forty-three fractures were followed up until healing, and three required reoperation for nonunion (two MVN, one AO-UHN). Nineteen MVN and 17 AO-UHN patients were evaluated according to Constant’s shoulder score and HSS elbow score after an average of 2 years (0.5–3.4 years). RESULTS Anesthesia time did not differ significantly in both groups. Differences in Constant’s shoulder score between healthy and affected side were more important in the AO-UHN group due to limitation in ROM and loss of abduction power. Differences in HSS elbow score were similar in both groups, although four supracondylar fractures occurred in the MVN group. CONCLUSION The retrograde approach to the humeral medullary cavity using a MVN resulted in better shoulder function and similar elbow function compared with the antegrade approach using an AO-UHN.