Clinical outcomes following intramedullary nailing of humerus fractures: a systematic review.

BACKGROUND: The purpose of this study is to systematically review the literature to assess clinical outcomes arising from intramedullary nailing (IMN) of humerus fractures. METHODS: Two independent reviewers performed a literature search in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported on patient-reported outcomes and range of motion following the use of IMN for humerus fractures between 2000 and 2023. RESULTS: A total of 88 studies, including 4255 patients, met the inclusion criteria for review. The majority of patients were female, with a mean age of 58.3 ± 12.4 years and a mean follow-up of 21.2 ± 15.2 months. The primary outcome score utilized for postoperative assessment was the Constant-Murley Score (CMS). The mean CMS for all fractures, proximal humerus fractures (PHFs), and humeral shaft fractures were 74.7 ± 12.5, 74.2 ± 12.3, and 77.3 ± 12.1, respectively. The mean CMS in 2-part, 3-part, and 4-part PHFs was 80.8 ± 8.8, 80.4 ± 12.3, and 66.5 ± 11.3, respectively. The primary range of motion measurements measured for postoperative assessment were forward flexion and external rotation. The mean forward flexion for all fractures, PHFs, and humeral shaft fractures was 135° ± 16°, 131° ± 13°, and 143° ± 18°, respectively. The mean external rotation for all fractures, PHFs, and humeral shaft fractures was 46° ± 15°, 43° ± 13°, and 52° ± 16°, respectively. CONCLUSION: IMN for humerus fractures provides good functional outcomes in both proximal humerus and humeral shaft fractures. However, functional outcomes in PHFs decreased as the number of displaced fracture parts increased.

Duke Scholars

Author Christopher Scott Klifto Orthopaedic Surgery

Author Oke Adrian Anakwenze Orthopaedic Surgery