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Antegrade nailing evolution for proximal humeral fractures, the Telegraph IV(®): a study of 67 patients.

Cuny C, Goetzmann T, Dedome D, Gross JB, Irrazi M, Berrichi A, Mayer J, Le Coadou PY, Precup S, Galois L, Mainard D - Eur J Orthop Surg Traumatol (2014)

Bottom Line: The primary outcome measure was the clinical Constant score.Notably, the complication rate was 67% for this latter group.This procedure does not appear suitable for displaced articular fracture for which arthroplasty may be indicated by elderly.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Metz Mercy Regional Hospital, CHR Metz Mercy, CS45001, 57085, Metz Cedex 03, France, c.cuny@chr-metz-thionville.fr.

ABSTRACT

Introduction: There are multiple surgical treatment methods for proximal humerus fractures (PHF), but rarely do they provide satisfactory results. The objective of this study was to assess radioclinical outcomes and complications in patients treated using a modern intramedullary nailing system the Telegraph I(®).

Materials and methods: This is an observational multicenter study cohort conducted between March 2008 and December 2009 on 105 patients admitted with a diagnosis of PHF and operated on two trauma I centers. The Neer and Articular Surgical neck Tuberosities classifications were used for the study. The primary outcome measure was the clinical Constant score. Follow-up of the patients was done at 6 weeks, 3 months, 6 months, 1 year, and 3 years after the procedure.

Results: A total of 67 patients (51 women and 16 men) were assessed at a mean of 38 months. The weighted Constant score was 88%. The mean rate of complications was 16%. The weighted Constant scores were 84 and 95% for the 2- and 3-part groups, respectively. Articular 4-part fractures had an average score of 86% when they were valgus impacted and 67% for complex disengaged fractures. Notably, the complication rate was 67% for this latter group.

Conclusions: Our clinical results support the use of this antegrade nailing for extra-articular and valgus-impacted articular fractures. This procedure does not appear suitable for displaced articular fracture for which arthroplasty may be indicated by elderly.

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Related in: MedlinePlus

T1 nail, proximal end
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Fig8: T1 nail, proximal end

Mentions: In addition, we selected to use the weighted Constant score for evaluating clinical results in our study. This scoring system is more representative as a functional result, as it takes away male/female differences in muscular strength and muscular degeneration in the elderly. In this regard, we observed a mean Constant weighted score of 88 %, which is satisfactory from a general viewpoint, despite the existence of a significant rate of complications (16 %). However, Popescu et al. [12] found a weighted Constant score of 76 % in a set of 21 patients treated using the Stryker T2 nail, whereas Boughrebi et al. [10] found a score of 82.5 % with the initial Telegraph. Thus, the clinical results from our patient population appear to be satisfactory in comparison with the current data on proximal humeral nailing (Fig. 8).Fig. 8


Antegrade nailing evolution for proximal humeral fractures, the Telegraph IV(®): a study of 67 patients.

Cuny C, Goetzmann T, Dedome D, Gross JB, Irrazi M, Berrichi A, Mayer J, Le Coadou PY, Precup S, Galois L, Mainard D - Eur J Orthop Surg Traumatol (2014)

T1 nail, proximal end
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4300429&req=5

Fig8: T1 nail, proximal end
Mentions: In addition, we selected to use the weighted Constant score for evaluating clinical results in our study. This scoring system is more representative as a functional result, as it takes away male/female differences in muscular strength and muscular degeneration in the elderly. In this regard, we observed a mean Constant weighted score of 88 %, which is satisfactory from a general viewpoint, despite the existence of a significant rate of complications (16 %). However, Popescu et al. [12] found a weighted Constant score of 76 % in a set of 21 patients treated using the Stryker T2 nail, whereas Boughrebi et al. [10] found a score of 82.5 % with the initial Telegraph. Thus, the clinical results from our patient population appear to be satisfactory in comparison with the current data on proximal humeral nailing (Fig. 8).Fig. 8

Bottom Line: The primary outcome measure was the clinical Constant score.Notably, the complication rate was 67% for this latter group.This procedure does not appear suitable for displaced articular fracture for which arthroplasty may be indicated by elderly.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Metz Mercy Regional Hospital, CHR Metz Mercy, CS45001, 57085, Metz Cedex 03, France, c.cuny@chr-metz-thionville.fr.

ABSTRACT

Introduction: There are multiple surgical treatment methods for proximal humerus fractures (PHF), but rarely do they provide satisfactory results. The objective of this study was to assess radioclinical outcomes and complications in patients treated using a modern intramedullary nailing system the Telegraph I(®).

Materials and methods: This is an observational multicenter study cohort conducted between March 2008 and December 2009 on 105 patients admitted with a diagnosis of PHF and operated on two trauma I centers. The Neer and Articular Surgical neck Tuberosities classifications were used for the study. The primary outcome measure was the clinical Constant score. Follow-up of the patients was done at 6 weeks, 3 months, 6 months, 1 year, and 3 years after the procedure.

Results: A total of 67 patients (51 women and 16 men) were assessed at a mean of 38 months. The weighted Constant score was 88%. The mean rate of complications was 16%. The weighted Constant scores were 84 and 95% for the 2- and 3-part groups, respectively. Articular 4-part fractures had an average score of 86% when they were valgus impacted and 67% for complex disengaged fractures. Notably, the complication rate was 67% for this latter group.

Conclusions: Our clinical results support the use of this antegrade nailing for extra-articular and valgus-impacted articular fractures. This procedure does not appear suitable for displaced articular fracture for which arthroplasty may be indicated by elderly.

Show MeSH
Related in: MedlinePlus