CLINICAL-PERFORMANCE OF THE SEIDEL HUMORA L LOCKING NAIL - BALANCE AFTER 100 APPLICATIONS

Between 01.01.88 and 30.07.94 we treated 81 traumatic and 19 pathologi c humeral shaft fractures with the Seidel humeral locking nail (HLN). The majority of tile 100 patients (60 women, 40 men) were older than 6 0 years of age. The dominant fracture type according to AO was type A. Operative stabilization was considered indicate because of fracture d istraction during functional bracing in most cases. In general, patien ts choose surgical intervention in preference to conservative manageme nt. Radiological consolidation was observed within 10 weeks. In 48 cas es sonography revealed motor disturbances between the gliding sheath o f the rotator cuff, but there was no correlation between this and the shoulder mobility. In 7 cases an additional fracture was created durin g introduction of the nail. This complication can be avoided by using the right technique. There were no cases of nonunion or radial nerve l esion. There were 2 patients who developed an infection, which disappe ared after removal of the nail and introduction of antibiotic-loaded b eads. Functional results were recorded in 63 patients: 53 patients (84 %) had an excellent or satisfactory result (NEER score >80). Among the others, problems at the site of nail insertion predominated. In our v iew, the Seidel humeral locking nail is an implant that provides exerc ise stability without intraoperative positioning problems or risk of i njury to nerves or vessels. Nevertheless, this method needs a skilled surgeon with special training to handle typical technical nailing prob lems.