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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2022; 63(03): e205-e214
DOI: 10.1055/s-0042-1744265
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Current Concepts: Advantages of Intramedullary Nail for Proximal Humerus Fractures

Article in several languages: español | English
Michael Marsalli 
1   Departamento de Traumatología y Ortopedia, Clínica Universidad de los Andes, Las Condes, Región Metropolitana, Santiago, Chile
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Abstract

Proximal humeral fractures are one of the most frequent fractures in the elderly population. Open reduction and internal fixation (ORIF) is generally indicated for young patients and older patients with high functional demands and good bone quality. No consensus has been reached regarding the ideal fixation technique. Although ORIF with plates is the most widely used technique, high re-intervention rates and global complications with locked plate fixation have been reported in the literature. Addition of augmentation techniques to locked plate fixation in complex fractures may result in longer surgical times, extensive approaches, and higher costs. Therefore, considering other options for ORIF is necessary. With a greater understanding of the mechanisms of fixation failure, intramedullary fixation has become the accepted treatment option for proximal humeral fractures considering the specific biomechanical and biological advantages. Compared with ORIF with locked plates, intramedullary fixation for proximal humeral fractures has low surgical time, intraoperative bleeding, time to bone union, and rate of infections. Intramedullary fixation is a valid option to resolve complex fractures with an implant that may largely supply all the augmentation requirements of a locked plate.

Keywords

proximal humeral fractures - internal fixation - intramedullary fixation - intramedullary nail - elderly fractures


Publication History

Received: 16 June 2021

Accepted: 10 January 2022

Article published online:
06 June 2022

© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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