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Osteosynthesis and Trauma Care 2003; 11: 44-47
DOI: 10.1055/s-2003-42295
Humerus

© Georg Thieme Verlag Stuttgart · New York

The Telegraph Nail® for Proximal Humerus Fractures, About 64 Cases at Two and a Half Years Follow-Up

C. Cuny1 , M. Irrazi1 , M. Khalife1 , P. Beau1 , M. Durand1 , O. Touchard1 , L. Darbelley1
  • 1Department of Orthopaedic Surgery and Traumatology, CHR Metz Hôpital Bon-Secours, Metz, France
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Publication History

Publication Date:
24 September 2003 (online)

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Abstract

The authors discuss the benefits and indications of the Telegraph nail in proximal humerus fractures. This technique is characterized by a lightweight nail locked by auto-stable screws to stabilize simple and complex fractures.
Patients and Methods: Between June 1998 and June 1999, a total of 64 patients were enrolled in the study (19 men, 45 women; mean age 69, range 15-89). The fractures were classified according to Neer and Duparc. Three different techniques were used for inserting the nail depending on the complexity of the fractures: standard, cup-and-ball and percutaneous techniques.
Results: Out of 64 patients, 45 underwent radiological and clinical examination with a mean follow-up of 29 months. The global rough Constant Score was 66.5 % and 90 % for the balanced one. There was a significant difference between the mean of amplitudes and Constant Score according to the nature of fracture. Two of three necroses in the entire study were in the group of complex fractures. There was a significant correlation between αF and αP angles of humeral head shift and the functional result.
Conclusion: The Telegraph nail has an excellent indication in 2, 3 and 4-part valgus impacted proximal humerus fractures. This technique is especially interesting when applied to complex, displaced or dislocated fractures with 4-parts, as an alternative to shoulder prostheses.

Key words

Shoulder - fractures - humerus - proximal humeral fractures - locking nail - Telegraph nail

References

  • 1 Bonnevialle P, Challe J J, Bullemore Y. Fractures sous tuberositaires.  Rev Chir Orthop. 1998;  84 (Suppl I) 143-148
    PubMedSearch in Google Scholar
  • 2 Chaix O, Lebalch T, Mazas F. Les fractures de l'extrémité supérieur de l'humé rus chez l'adulte: Classification et indications thé rapeutiques.  Ann Chir. 1984;  38 220-227
    PubMedSearch in Google Scholar
  • 3 Clifford P C. Fractures of the neck of the humerus: a review of the late results.  Injury. 1980;  12 91-95
    CrossrefPubMedSearch in Google Scholar
  • 4 Cofield R H. Comminuted fractures of the proximal humerus.  Clin Orthop. 1988;  230 49-57
    PubMedSearch in Google Scholar
  • 5 Cuny C, Scarlat M, Irrazi M, Slimani S, Turell P. Enclouage des fractures proximales de l'humérus par clou Télégraph à verrouillage auto-stable. Technique et premiers ré sultats à propos de 66 cas. 75e réu-nion annuelle de la SOFCOT. Rev Chir Orthop 2000
  • 6 Cuny C, Pfeffer F, Irrazi M, Chammas M, Empereur F, Berrichi A, Metais P, Beau P. Un nouveau clou verrouillé pour les fractures proximales de l' humérus.  Rev Chir Orthop. 2002;  88 62-67
    PubMedSearch in Google Scholar
  • 7 Duparc J, Massin P, Huten D. Classification des fractures de l'extrémité supérieure de l'humérus. Dans fractures récentes. Cahiers d'enseignement de la SOFCOT n° 56. Exp Scient Fr, Paris 1996; 27-37
  • 8 Duparc F, Huten D. Le traitement conservateur des fractures de l'extrémité supérieure de l'humérus. Symposium de la SOFCOT.  Rev Chir Orthop. 1998, Suppl 1;  84 121-189
    PubMedSearch in Google Scholar
  • 9 Gaullier O, Rebai L, Dunaud J L, Moughabghab M, Benaissa S. Traitement des fractures récentes de la diaphyse humérale par enclouage centro-médullaire verrouillé selon Seidel.  Rev Chir Orthop. 1999;  85 349-361
    PubMedSearch in Google Scholar
  • 10 Hawkins R J, Switlyk P. Acute prosthetic replacement for severe fractures of the proximal humerus.  Clin Orthop. 1993;  289 156-160
    PubMedSearch in Google Scholar
  • 11 Huten D, Duparc J. L'arthroplastie prothétique dans les traumatismes complexes récents et anciens de l'épaule.  Rev Chir Orthop. 1986;  72 517-529
    PubMedSearch in Google Scholar
  • 12 Kraulis J, Hunter G. The results of the prothetic replacement in fractures-dislocations of the upper end of the humerus.  Injury. 1979;  8 129-131
    PubMedSearch in Google Scholar
  • 13 Marotte J H, Lord G, Bancel P. L'arthroplastie de Neer dans les fractures et fractures luxations de l'épaule. A propos de 12 cas.  Chir. 1978;  104 816-821
    PubMedSearch in Google Scholar
  • 14 Neer C S. Displaced proximal humeral fractures. Part I: Classification and evaluation.  J Bone Joint Surg [Am]. 1970;  52 1077-1089
    PubMedSearch in Google Scholar
  • 15 Neer C S. Displaced proximal humeral fractures. Part II. Treatment of three-part and four-part displacement.  J Bone Joint Surg [Am]. 1970;  52 1090-1103
    PubMedSearch in Google Scholar
  • 16 Pietu G, Deluzarches P. Traumatismes complexes de l'extrémité supé rieure de l'humérus traités par prothèse céphalique. A propos de 21 cas revus avec un recul moyen de 4 ans.  Acta Orthop Belg. 1992;  58 159-168
    PubMedSearch in Google Scholar
  • 17 Scheid K D. Proximal humerus fractures: an unsolved fracture?. Final program, 66th Annual Meeting. American Academy of Orthopaedic Surgeons 1999
  • 18 Bell S N, Gschwend N. Clinical experience with total arthroplasty of the shoulder using the Neer prosthesis.  International Orthop (SICOT). 1986;  10 217-222
    PubMedSearch in Google Scholar
  • 19 Svend-Hansen H. Displaced proximal humeral fractures. A review of 49 patients.  Acta Orthop Scand. 1974;  45 359-364
    PubMedSearch in Google Scholar
  • 20 Zyto K, Wallas W A, Simon P, Frostick S P. Outcome after hemiarthroplasty for three and four part fractures of the proximal humerus.  J Shoulder Elbow Surg. 1998;  7 85-89
    CrossrefPubMedSearch in Google Scholar

C. Cuny M. D. 

Department of Orthopaedic Surgery and Traumatology

CHR Metz Hôpital Bon-Secours

1 place de Vigneulles

57038 Metz cedex

France

Phone: +33/3 87 55 31 88

Fax: +33/3 87 55 39 34

Email: c.cuny@chr-metz-thiannille.rss.fr