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

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

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