上腕骨近位端骨折に対する順行性横止め髄内釘手術の合併症 ∼ Multicenter Study ∼

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Background: Intramedually nailing is widely used for proximal humerus fractures. The purpose of this study was to evaluate our incidence of complications following surgeries for proximal humerus fractures using one of locking intramedullary nails, the New Straight Nail System. Methods: We performed a retrospective multicenter study about proximal humerus fractures treated with the New Straight Nail System (Nakashima, Japan) at our affiliated hospitals. 193patients (193fractures) with mean age 70 years were treated at the twelve hospitals between January 2008 and February 2011. In the 193fractures, there was one patient with one part fracture according to Neer's classification, 114patients with two parts, 49patients with three parts and 29patients with four parts. All the surgeries followed the standard protocol using the New Straight Nail. Intraoperative, and postoperative complications were investigated. The average duration of follow-up was 18.5 months. Results: Complications were seen in 21patients(10.9%). Two patients had temporal axillary nerve palsy as an intraoperative complication. Postoperative complications were seen in 19patients. Three patients had a screw back-out. Re-displacement was seen in four patients, progress of the collapse of the humeral head in three patients, nonunion and subacromial impingement in two patients, bone resorption of the greater tuberosity, a hematoma and deep infection in one patient. There were two patients who had ischemic stroke at seven days and 16days postoperatively. The second surgeries were required in eight patients (4.1%) who had a screw back-out, nonunion, collapse of the humeral head, hematoma and deep infection. Conclusion: The current study shows low complication rate of surgeries with the New Straight Nail System.

上腕骨近位端骨折に対する順行性横止め髄内釘手術の合併症<BR>∼ Multicenter Study ∼

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