• Dinko Vidović, Ivan Benčić, Tomislav Ćuti, Domagoj Gajski, Tomislav Čengić, Marijo Bekić, Mario Zovak, Srećko Sabalić, and Dejan Blažević.
• 1Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Surgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, University of Split, Split, Croatia; 6University of Applied Health Sciences, Zagreb, Croatia; 7Orthopedic and Traumatology Department, Dubrovnik General Hospital, Dubrovnik, Croatia; 8Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
• Acta Clin Croat. 2019 Dec 1; 58 (4): 632-638.

AbstractThe aim of this study was to compare union time between two different nail designs for the treatment of humeral shaft fracture, i.e. antegrade interlocking intramedullary nail with and without additional interlocking neutralization screws. The retrospective study included 51 patients treated with antegrade humeral intramedullary nailing between January 2015 and December 2017. The inclusion criteria of the study were proximal and middle third humeral shaft fractures. Fifty-one patients met the inclusion criteria; 23 patients were treated with antegrade intramedullary nail with additional interlocking neutralization screws through fracture site (group A) and 28 patients were treated with antegrade intramedullary nail without additional interlocking neutralization screws (group B). Medical documentation and radiographic images taken preoperatively and postoperatively were reviewed. Radiological union was defined as cortical bridging of at least three of four cortices in two-plane radiographs, with disappearance of the fracture gap. There were no significant differences in union time between the groups (p>0.05). To our knowledge, this is the first report of antegrade interlocking humeral nailing with additional interlocking neutralization screws through fracture site. Hypothetical advantages of fracture gap reduction by additional interlocking neutralization screws to promote union were not confirmed by this first clinical trial.

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