Clinical Trial: Rotator Cuff Injury in Antegrade Locked Nailing for Humeral Fractures

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Sonographic Evaluation of Rotator Cuff Injury in Antegrade Locked Nailing for Humeral Fractures

Brief Summary: The purpose of this study is to investigate the potential insults of rotator cuff muscle and the functional recovery of upper extremity function after antegrade nailing of humeral fractures.

Detailed Summary:

Background:

With improved implant design and surgical technique, operative treatment of humeral shaft fractures increasingly has become accepted. Such treatment offers several advantages. The rigidly fixed, fractured limb can be used early without external support, and the patient can sleep, as normal, in the supine position. In addition, the angular deformity often seen with conservative treatment effectively is prevented. Although plate osteosynthesis can afford a rigid fixation and good functional recovery, its disadvantages have been reported. By comparison, locked nailing, which provides sufficient fixation stability and prevents slipout of the nail, offers the advantages of less soft tissue injury, a lower infection rate, and no need for radial nerve extrication. Locked nailing is preferred especially for open fractures, comminuted fractures, pathologic fractures, and fractures associated with osteoporosis. The use of Seidel locked nails with spreading fins can be complicated by inadequate fixation, intraoperative bone comminution, and unsatisfactory recovery of shoulder function. Biomechanically, locked nails with transfixing locking screws allow much better rotational control of the distal fragment than do Seidel nails. Most rigid humeral nails are inserted antegrade, but a disadvantage to antegrade nailing has been the risk of shoulder function impairment, which partially negates the advantages of closed nailing and of loadsharing mechanical properties. The disadvantages of retrograde nailing are potential risk of elbow joint injury and nonlinear entry portal of nailing.

Gaullier O et al did a study of 23 cases with rotator cuff evaluation in 1999. Only humeral diaphyseal fractures were enrolled. Fracture type classification was according to AO. Clinical shoulder assessment was carried out using the Constant score
Sponsor: National Taiwan University Hospital

Current Primary Outcome: Sonographic finding, functional recovery [ Time Frame: at least 12 months ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Radiographical finding [ Time Frame: at least 12 months ]

Original Secondary Outcome: Same as current

Information By: National Taiwan University Hospital

Dates:
Date Received: October 14, 2008
Date Started: October 2008
Date Completion:
Last Updated: July 14, 2010
Last Verified: July 2010