[Treatment of humeral shaft fractures with the Marchetti nail: 50 cases]

E Butin, S Herent, P Delehaye
Revue de Chirurgie Orthopédique et Réparatrice de L'appareil Moteur 2001, 87 (8): 758-64

PURPOSE OF THE STUDY: There is no universal agreement concerning the most appropriate method for treating humeral shaft fractures. Orthopedic treatment was long proposed due to the risks of surgical management. Screwed plate fixation raises the risk of infection, neurological injury and nonunion. Anterograde nailing can lead to subacromial conflicts. The purpose of this study was to analyze results of an elastic retrograde nailing technique using the Marchetti nail. This method would appear to offer the advantages of closed osteosynthesis without interrupting the rotator cuff.

MATERIAL AND METHODS: Fifty fresh traumatic fractures of the humerus were treated with Marchetti nailing between December 1995 and June 1999. Ten patients had died at last follow-up after having achieved bone healing. Outcome was assessed at a mean 22 months post-surgery for 39 patients. The AO classification and the Hackethal classification modified by De la Caffinière were used. Outcome was assessed according to the Stewart and Hundley classification.

RESULTS: Very good outcome was achieved in 13 patients (33%), good outcome in 21 (54%) and poor outcome in 5 (13%). The assembly dismounted in 1 patient who required revision for pin insertion. Two cases of nonunion and two cases with poor function were observed. Mean delay to union was 10 weeks. There were no cases of infection or iatrogenic radial nerve palsy. Secondary fracture at material ablation occurred in 2 cases.

DISCUSSION AND CONCLUSION: Closed fixation is an advantage of this method (minimal risk of infection and radial injury). In addition, the rotator cuff is not perturbed. The drawbacks include the risk of secondary fracture, almost exclusively at ablation.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"