Abstract

Aim: To evaluate the functional outcomes of titanium elastic nail system in fractures of humerus.

Study Design: Prospective study

Place and duration of study: Orthopedic Department, King Fahad General Hospital, Jeddah, Kingdom of Saudi Arabia from 1^st July 2017 to 30^th2019.

Methodology: Fifty patients with mature skeleton mature with closed fractures of shaft/distal one third of humerus managed through titanium elastic nailing system were included where as other types of fractures and immature skeleton patients were excluded.The surgical techniqueused was the antegrade/retrograde entry points elastic nails for managing the mid-shaft fracture whereas the fractures of the distal one third fractures were managed with antegrade entry point. Immobilization was achieved with sling over 2-3 weeks and analgesics were used for pain management with a postoperative follow up on 2^nd,6^th and 12^th  weeks while radiographic union as well as range of movement was assess even after one  year.

Results: There were 50 patients enrolled in this study and followed up for one year out of which male patients were 74% and females were 26% and the mean age of our patients was 27±4years. Polytrauma patients were in majority with 60%, bending wedge fractures were 19%, oblique fractures were 15% and rest were of transverse nature. The union rate was 98% with the union time of 8-16 weeks. Non-union was observed in one patient (2%) that was repeated with plate osteosynthesis. Functional range of motion at shoulder and elbow joints was achieved in 47(94%) in patients while elbow stiffness was seen in 3(6%) patients requiring manipulation under anesthesia, radial nerve damage was seen in 3(6%) patients post-operatively and both recovered during the follow up period.

Conclusion: The mention technique was found to beacceptable method for managing the mid-shaft fractures and distal third fractures of humerus with excellent union and nice functional outcomes and less complication rates.

Keywords: Titanium elastic nail, Shaft fractures, Union, Functional outcomes