Objectives: To investigate the results of two-part surgical neck fractures of proximal humerus treated with locking intramedullary nail for proximal humerus, and to discuss the indication, surgical technique and the effectiveness.
Methods: The data of the 22 patients with two-part surgical neck fractures fixed with proximal humeral nail was retrospectively reviewed. The mean age was 57 years. X-ray film and visual analogue scale (VAS), American shoulder and elbow surgeon (ASES) score, Constant-Murley score, University of California, Los Angeles (UCLA) scoring system and simple shoulder test (SST) questionnaire were used to evaluate the patients' shoulder function recovery at final follow-up.
Result: All the patients were followed up with an average time of 13 months. All fractures united within 8 weeks postoperatively. No infection, avascular necrosis or complications which concerning with hardware was found during follow-up. The average active forward flexion was 147.8 degrees , the average external rotation was 45.5 degrees and the average internal rotation was T10. The mean VAS score was 1.5. The mean ASES score, Constant-Murley score, UCLA score and SST score were 81.2, 85.4, 29.9 and 9.5 respectively. Eighteen patients were rated as "excellent" or "good", while 4 others were rated "poor". All patients were satisfied with their results.
Conclusion: With good indication control, meticulous intraoperative management and strict postoperative rehabilitation, close reduction and internal fixation with proximal humeral nail can be an effective method for the treatment of two-part surgical neck fracture.