Humeral shaft fracture: outcomes of percutaneous antegrade intramedullary nailing using the Telegraph® straight nail with dynamic distal locking

Antegrade intramedullary nailing in humeral shaft fracture has been abandoned by certain orthopedic surgeons due to rotator cuff injury caused by curved nails, and to unreliable anatomic results. The purpose of this study was to report outcomes of straight percutaneous intramedullary nailing with dynamic distal locking in humeral shaft fractures. Percutaneous antegrade intramedullary nailing using a long straight nail with dynamic distal locking improves radiological and functional outcome in humeral shaft fracture. A retrospective study recruited 76 patients undergoing straight percutaneous antegrade intramedullary nailing with dynamic distal locking for isolated closed displaced humerus shaft fracture between January 2008 and June 2018. Eighteen patients were excluded; 36 were further followed up in June 2018 to assess Constant score. There were 35 women and 23 men, with a mean age of 53 years. All fractures were closed: 36 type A, 16 type B and 6 type C on the AO/OTA classification. Healing was achieved in 97% of cases, at a mean 13±3 weeks. There were no cases of infection or secondary nerve damage. Mean Constant score was 78±13. Surgical treatment of humeral shaft fractures is a subject of discussion, without consensus. Based on our experience, percutaneous antegrade intramedullary nailing with dynamic distal locking improves anatomical and functional results, provided that the surgical technique is mastered, which involves a learning curve. IV, retrospective.