上腕骨近位端骨折に対する Pin lock nail TM を用いた固定術

概要

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Background: Fractures of the proximal humerus are common. In elderly patients, osteoporosis makes internal fixations problematic. We developed a new intramedullary nail (pin lock nail; PLN) for a proximal humeral fracture. The purpose of this study was to evaluate the surgical outcome for a proximal humeral fracture with PLN. Methods: We operatively treated 20 patients with PLN. There were 8 males and 12 females, with a mean age of 65 years. Mean duration of follow-up was 9 months. There were 7 Neer's 2-part fractures, 12 3-part fractures and a valgus impacted fracture. Clinical results were evaluated using the JOA score (pain, activity of daily life (ADL) and range of motion (ROM)). Elevation range of the affected shoulder was expressed as a percentage of the unaffected side. Results: All fractures had healed. No backing out of the pin and screw was seen at the time of last follow-up. The mean pain score was 24.0 points. The mean ADL score was 8.5 points . The mean ROM score was 22.3 points. The percentage of elevation range was 82.1%. Conclusion: PLN has an original locking system to fix the pins in high-density born area by means of a plug. This system prevents backing out of the pins. Furthermore, the nail, with a curvature of 15°, avoid splitting the supraspinatus. The present study showed good clinical results without complication. PLN seemed to be useful internal fixation method for a proximal humeral fracture.