Introduction: Proximal humeral fracture is 3rd most common fracture in elderly population.
Selection of appropriate implant is always challenging to get optimum results in these
osteoporotic bones. Though locking plates are gold standard, major complications range from
9% to 36%. Many percutaneous fixation techniques described in the literature are associated with pin site infections, pin backout and loss of reduction.
Objective: To study clinical and radiological outcome of J nail technique for Neer’s three or
four part proximal humeral fractures in patients more than 60 years age.
Materials and Method: We retrospectively studied 60 patients of 3 or 4 part proximal humeral fractures, >60 years of age treated with J nail technique from the period of 2015 to 2017. J nails were made using 2 mm 12 inches blunt tip L (Lambrinudi) wires. At final follow-up, clinical outcome was assessed using Constant Score and radiological evaluation was done according to the Bahr criteria. Statistical analysis was performed.
Results: The mean Constant Score at final follow-up was 90. The postoperative reduction was excellent in 98% of patients and remained excellent in 90%. The mean postoperative neck shaft angle was 135.0° and final neck shaft angle was 131.4°. No deep infection was seen. No avascular necrosis of humeral head was found till follow up upto 2 yrs.
Conclusions: Our study suggests that the functional and radiological outcomes obtained with J nailing are excellent and similar to locking plates and percutaneous Kirschner wire fixation with many other advantages of being simple, minimally invasive, avoiding muscle transfixation and no pin site infections. This surgical technique can be considered as one of the effective technique for fixation of proximal humeral fractures in elderly osteoporotics.