| The humeral shaft fracture is one of clinical common types. In the past time ,conservative therapy was the main method and achieved good results.Along with the development of materials of internal fixation, Replacement of fractures and functional recovery were desired highly to patients ,so operating treatment become mainstream.It has been recognized that fracture of shaft of femur and tibial shaft is treated by interlocking intramedullary nail.But whether it is ideal internal fixation to humeral shaft fracture,the treatment is disputed constantly.The study can analysis the clinical effects of interlocking intramedullary nail on the treatment of humeral shaft fracture .Objective To approach clinical efficacy on the treatment of humeral shaft fracture by interlocking intramedullary nail .Methods It is to summarize experience in the treatment of 37 cases of humeral shaft fracture by interlocking intramedullary nail and retrospective analysis of prognosis in the third clinical hospital of JiLin University. 37 cases patients of humerus shaft fracture (male 22,female 15,18-62 years old, the mean age is 32.3, )were treated with interlocking intramedullary nail,of whom 21 cases were treated with antegrade interlocking intramedullary nail and 16 cases with retrograde interlocking intramedullary nail.There are 7 cases patients of closed fracture and 30 cases patients of compound fracture. There are 5 cases patients of radial nerve injury. The reasons of injury is that 22 cases patients is due to road accident,8 cases patients is due to tumbling injury, 4 cases patients is due to crashed injury,and 3 cases patients is due to falling injury. Associated injury:2 cases patients are fracture of collar bone,6 cases patients are fracture of forearm, 4 cases patients are fracture of tibiofibula,3 cases patients are fracture of femur, 2 cases patients are pelvic fracture ,and1 cases patients is spine fracture.The type of fracture adopt AO classification system:Type A in 19 cases, Type B in 15 cases, Type C in 3 cases.The study can evaluate the effect of surgery in these areas Such as the time of operation,the rate of healing,the healing time,radial nerve injury,bone non-union,Shoulder Elbow dysfunction.Result Intramedullary nail is enough strong fixation that can load early and good recovery with function.The average operation time is 70 minutes,37 cases patients are cured with interlocking intramedullary nail. 29 cases were followed up, the mean Follow-up period was 13.2 months(ranging 3 to 22 months). All patients'incision are I/ the first rate healing.There was no delayed union,nonunion and malunion or infection in all the cases.5 cases patients of radial nerve injury have recovered six months later. After operated four weeks,there were a small amount of callus formation around bone fracture. The average period of bone healing was 11 weeks. The healing of fracture was per secundam intentionem, bony callus growed richly and distributed uniformly. All internal fixation have not broken.12 cases patients took nail again after operated 8-13 months.After operation Shoulder function was assessed by Neer's score. 13 cases showed excellent results(61.9%), 7 cases showed good results(33.3%), 1 cases showed fair results(4.8%), none showed poor results. The activities of elbow joint is normal without adverse effects.After operation there were Six patients with varying degrees of radial nerve injury (radial nerve of five cases have been damaged before operation). It recovered four–six months later.conclusion Interlocking intramedullary nail of humerus is a reliable method to treat fracture of shaft of humerus.The methods have Fewer complications, a high rate of bone healing, a good functional recovery . However, it must be requested by a good positioning, the accurate windowing location, the correct direction of needling, sophisticated technology, a stable locking, which can effectively reduce the impact of surgery on the shoulder joint function and the incidence of complications that are the key to success.
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