• Jordi Salvador, Samer Amhaz-Escanlar, Pablo Castillón, Iban Clares, Saioa Quintas, Martí Bernaus, Francesc Anglés, and Alberto Jorge-Mora.
• Servei de Cirurgia Ortopedica i Traumatologia, Hospital Universitari Mutua Terrassa, Spain.
• Injury. 2019 Feb 1; 50 (2): 415-419.

PurposeAntegrade intramedullary nailing is an alternative for humeral shaft fracture treatment. This surgical technique can be especially demanding in some fracture patterns, leading to problems like malunion and non-union. The purpose of our study is to demonstrate that the use of a nail with cerclage wires could be a safe procedure that facilitate reduction, specially in fractures with abduction of the proximal fragment.Materials And MethodsFifty-six patients were included, from January 2007 to March 2016. In this cohort forty-two patients were females and eighteen males; mean age was sixty-seven (32-89). The fractures were reduced using a cerclage wire through a small lateral or anterior approach, then, antegrade intramedullary nailing was performed. Fracture healing was established by clinical and radiographic evaluation. Shoulder function was assessed using the Constant Score.ResultsFifty-three patients healed (94.6%) adequately. Two patients developed a non-union (3.5%). One patient developed an infection (1.8%). Transient radial nerve palsy was observed in two patients (3.5%). The mean Constant Score at the end of the study was 70 points (range from 34 to 98 points).ConclusionsSurgical treatment of humeral shaft fractures with cerclage wire and intramedullary nailing is a safe technique to improve fracture reduction. The use of cerclage wires leads to better bone contact while minimizing malunions. The rate of non-union in our study is lower than the rate reported in the literature for humeral shaft fractures treated by intramedullary nailing alone.Copyright © 2018 Elsevier Ltd. All rights reserved.

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