Impacto clínico en el hombro del enclavijamiento endomedular anterógrado en el tratamiento de fracturas de la diáfisis humeral

Daniela Gutiérrez-Zúñiga; Alejandro Mejía-Grueso; Raúl Ernesto González; Felipe Valbuena-Bernal

doi:10.58814/01208845.5

Authors

Daniela Gutiérrez-Zúñiga Hospital Universitario San Ignacio, Orthopedics and Trauma Service, Bogotá D.C., Colombia. | Pontificia Universidad Javeriana, Faculty of Medicine, Specialty in Orthopedics and Trauma, Bogotá D.C., Colombia https://orcid.org/0000-0001-6852-0350
Alejandro Mejía-Grueso Hospital Universitario San Ignacio, Orthopedics and Trauma Service, Bogotá D.C., Colombia. | Pontificia Universidad Javeriana, Faculty of Medicine, Specialty in Orthopedics and Trauma, Bogotá D.C., Colombia. | Hospital Universitario de la Samaritana, Orthopedics and Trauma Service, Bogotá D.C., Colombia. https://orcid.org/0000-0001-8926-9724
Raúl Ernesto González Hospital Universitario de la Samaritana, Orthopedics and Trauma Service, Bogotá D.C., Colombia. https://orcid.org/0000-0003-2939-3891
Felipe Valbuena-Bernal Hospital Universitario San Ignacio, Orthopedics and Trauma Service, Bogotá D.C., Colombia. | Pontificia Universidad Javeriana, Faculty of Medicine, Specialty in Orthopedics and Trauma, Bogotá D.C., Colombia. | Hospital Universitario de la Samaritana, Orthopedics and Trauma Service, Bogotá D.C., Colombia. https://orcid.org/0000-0002-1993-3797

DOI:

https://doi.org/10.58814/01208845.5

Keywords:

Fracture fixation, Intramedullary, Rotator cuff, Subacromial impingement syndrome, Humeral fracture

Abstract

Introduction: Intramedullary nailing (IN) is a common therapeutic option for humeral shaft fractures. However, some patients treated with IN develop signs of subacromial impingement and decreased strength in flexion and abduction movements.

Objective: To evaluate the clinical impact of the use of antegrade IN on the shoulder for the treatment of humeral shaft fractures in terms of pain, functionality, and subacromial impingement symptoms. Methodology: Retrospective observational study carried out in 25 adult patients with humeral shaft fractures treated with antegrade IN. Follow-up was performed 6 to 12 months after the procedure, assessing functionality (arcs of motion and QuickDASH scale), as well as the presence of pain (visual analog scale [VAS]) and signs of subacromial impingement (according to Yocum, Neer and Hawkins-Kennedy). Data are described using absolute and relative frequencies for qualitative variables and means and standard deviations for quantitative variables.

Results: The mean anterior flexion, QuickDASH score, and VAS score were 145° (±31.6), 6.1 (±8.5), and 2.32 (±2.06), respectively. One or more signs of subacromial impingement were observed in 32% of the patients. In addition, complete fracture healing occurred in all cases.

Conclusion: Given that no significant impact on the shoulder was evidenced in terms of mobility, pain or signs of subacromial impingement and that fracture healing occurred in all cases, IN was adequate for the treatment of humeral shaft fractures.

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