Treatment of Acute Proximal Humerus Fractures With a Polarus Nail

Fourteen patients with acute displaced proximal humerus fractures were treated with a proximal locked antegrade humeral intramedullary nail (Polarus nail). These patients were treated by one surgeon and records were reviewed retrospectively. Clinical outcome measurements included active elevation and external rotation; a functional outcome measure, the Shoulder Pain and Disability Index (SPADI); and complications. Radiographic outcome measures were union, alignment, and presence of avascular necrosis. All 14 fractures went on to clinical and radiographic union. Mean time to union was 4 months (range, 2–9 months). Four patients had postoperative complications. Mean SPADI score was 30 (good) (range, 4–67). There were no cases of postoperative avascular necrosis, and the average radiologic neck/shaft angle was 121° (range 90° –144°). The proximal locked antegrade humeral intramedullary nail used in the treatment of displaced proximal humerus fractures results in predictable union and good alignment and function. (Journal of Surgical Orthopaedic Advances 18(1):28–34, 2009)