Closed interlocking nailing of humeral shaft fractures with the Russell-Taylor nail

Objective: To assess the role of the Russell-Taylor humeral nail in the tre atment of humeral shaft fractures. Study Design: Retrospective with a mean radiologic and clinical follow-up a t thirty-two months. Setting: University teaching hospital. Patients: Total of thirty-seven patients treated with the Russell-Taylor hu meral nail. Intervention: All patients were treated with the Russell-Taylor humeral nai l inserted in an antegrade fashion. Outcome Measures: Radiologic union and shoulder function in terms of pain, power, range of movement, and activities of daily living. Results: There were four established nonunions and four cases of delayed un ion (time to union > four months). Age of patient was the only predictor of nonunion. There was one infection and one intraoperative fracture. Two pro minent proximal screws required removal, and one nail was removed after uni on because of impingement. Three patients required manipulation under anest hesia to improve shoulder movement. At review, six patients had residual po or shoulder function as per Constant score, four attributable to shoulder s tiffness and two to residual pain. Conclusion: The authors' findings indicate a significant rate of delayed or nonunion in the elderly patient. When the high rate of union with conserva tive treatment is considered, the indications and rationale for intramedull ary humeral nailing should be clearly defined.