THE USE OF INTERLOCKING NAIL FOLLOWING SE IDEL IN RECENT DIAPHYSEAL FRACTURES OF HUMERUS - 41 CASES REVIEWED OF 48 FRACTURES

The Seidel's humeral interlocking nail is used in our department since december 1986. We report about the 48 first cases, 41 of them have be en reviewed with a mean time follow up of 14 months. The indications w ere humeral mid-shaft fractures with associated lesions (20 cases), fa ilures of non operative treatment (10 cases) and compound fractures (7 cases). Primary radialis nerve lesions has to be explored before nail ing. In 41 cases we used a static procedure; post-operative immobilisa tion average time : were 13 days. Consolidation occured in all cases w ithin an average time of 10.5 weeks. Post-operative complications cons isted in 1 case of infection healed after removal of the nail, and 1 c ase of secondary displacement after dynamic nailing with secondary rad io-circumflex paralysis. The results were appreciated concording to th e criteria of Stewart and Hundlay. We noted 64 per cent excellent and good results for fractures of the upper third, 80 per cent for fractur es of the middle third and 85 per cent for the distal third of the dia physis. All transverse fractures had a very good result but also the t ransverse and spiral fractures with third fragment which represent ver y unstable fractures especially at the upper third. The closed interlo cking nailing of the humeral fractures according to Seidel represents a reliable and stable fixation method. Consolidation occurs in all cas es whatever the type or the level of fracture.