The Journal of Bone and Joint Surgery, Vol 69, Issue 4 558-567, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Ender nailing of acute fractures of the humerus. A study of closed fixation by intramedullary nails without reaming
RF Hall and AM Pankovich
A prospective study of closed intramedullary fixation of fractures of the
shaft of the humerus, using Ender nails, was performed over a six-year
period. Eighty-nine fractures in eighty-eight patients were treated with no
immobilization postoperatively. Three patients were lost to follow-up.
Eighty-five of the remaining eighty-six fractures healed, the average time
to clinical union being 7.2 weeks. Non-union of one fracture occurred and
there were no infections or malunions. Six of the nine preoperative and two
postoperative radial-nerve palsies were lesions in continuity and healed
spontaneously. The remaining three radial nerves that had been severed by a
missile needed further attention. One of the nails backed out in eight
patients, requiring revision in five. The average lack of complete
extension of the elbow was 4 degrees and flexion of the elbow was 132
degrees. Abduction of the shoulder averaged 91 degrees; external rotation,
54 degrees; and internal rotation, 68 degrees. We conclude that closed
intramedullary Ender nailing can be performed safely and effectively in
selected fractures of the humeral shaft. However, only fractures that are
recalcitrant to closed reduction and immobilization or fractures in the
non-compliant patient should be considered for this form of operative
treatment.
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