Functional Outcomes After Proximal Humeral Nail Fixation
Proximal humerus fractures hit hard, especially in older folks from falls or younger ones in high-impact crashes. Surgeons often grab proximal humeral nails (PHNs) for these tricky breaks because they slide right into the bone marrow canal, sparing muscles and letting patients get moving quickly. Studies show solid recovery rates, with most hitting good shoulder function by six months post-op.
Nail Basics and Why They Shine These nails act like an internal splint, with locking screws up top grabbing the fractured head and tuberosities while the shaft stabilizes below. Unlike bulky plates that strip deltoid tissue, PHNs mean smaller cuts, less bleeding—around 100ml versus 200ml for plates—and ops wrapping in under an hour. That minimal mess cuts infection risks and speeds rehab, key for osteoporosis cases where bone's like chalk.
Scorecard on Real Results Constant-Murley scores, the gold standard for shoulder checks, often land in the 80s for PHN patients at one year—think forward flexion over 130 degrees, decent abduction, and external rotation around 40 degrees. DASH scores drop to the low 20s, meaning folks handle daily chores without much gripe. In one batch of 20 nailed patients, progress outpaced plate groups, with quicker gains in pain-free motion and strength. Unions happen by 12 weeks, and early weight-bearing keeps stiffness at bay.
Who Does Best and Pitfalls? Younger patients or two-part fractures crush it—excellent outcomes in over 60%—but complex four-partners in elders might settle into moderate territory, scores dipping to 60s. Complications? Rare under 10%: screw cutouts or head collapse in shaky reductions, but way less than plates' hardware irritations. Blood loss stays low, no big nonunions, and most ditch slings by week two for physio.
Head-to-Head with Plates PHNs edge out variable angle locking plates like proximal humerus plates on speed and soft tissue love—shorter surgeries, half the blood, better 12-month Constants and DASH drops. Plates pull ahead in super-simple breaks, maybe, but nails win for shafts blending into heads, mobilizing faster with fewer avascular headaches. One review nailed it: no outcome differs long-term, but nails mean less hassle upfront.
Everyday Wins and Patient Stories Picture a 65-year-old grandma back gardening three months out, or a biker dude swinging a golf club by six. Flexion hits 140 degrees routinely, with grip strength rebounding 80% normal. Elderly osteoporosis stars here—nails lock into what bone exists, dodging plate pullouts. Rehab's straightforward: pendulums day one, resistance by week four.
Future Tweaks and Tips Newer multi-lock designs tweak angles for tuberosity grabs, slashing rotations. Watch for over-reaming to avoid fat emboli, and nail early—within 72 hours—for top unions. As active seniors boom, PHNs stay hot, blending stability with biology for shoulders that actually work again.
Contact Information Address:- WZ- 1, 2nd Floor, Phool Bagh, Ram Pura, New Delhi, 110035 INDIA Mobile :- +91 9810021264 Mail:-
[email protected] Website:- https://www.siiora.com/ Source:https://traumaimplant.poetry.blog/functional-outcomes-after-proximal-humeralnail-fixation/
