Intramedullary Nailing of Humerus Fractures Using an Implant System with Internal Distal Locking and Avoiding Distal Incisions: Operative and Clinical Outcomes

There is limited evidence to guide implant selection for humeral shaft fractures. The objective of this study was to evaluate operative differences, early outcomes, and complications associated with use of an intramedullary nailing (IMN) system without distal interlock screws and compare this to a standard humeral nailing system. We evaluated 49 consecutive patients who underwent IMN for humeral shaft fracture between 2015–2018. Patients were grouped based on implant; Stryker T2 Nail (n = 37), or ODI Talon DistalFix (n = 12), which achieves distal interference with an endocortical barb mechanism. Operative time using the T2 nail was significantly longer than DistalFix nails (90 vs. 64 minutes, p < 0.05). With the numbers available, there was no significant difference in estimated blood loss for both systems (114 vs. 97 ml, respectively; p = 0.6). Neurologic complications occurred in eight versus one patient in the T2 and DistalFix cohort, respectively. These fi ndings may support increased shifts to implant systems that bypass distal interlocking systems for cost savings and patient/surgeon safety. (Journal of Surgical Orthopaedic Advances 31(1):012–016, 2022)

Key words: humeral shaft fracture, intermedullary nail, interlock, bar bed nail, operative efficiency