The Polarus intramedullary nail for proximal humeral fractures: outcome in 28 patients followed for 1 year.

BACKGROUND: One of the new treatment options for proximal humeral fractures is the minimally invasive intramedullary nail. In this study, we reviewed the early clinical results after 1 year. PATIENTS AND METHODS: 35 patients with proximal humeral fractures were treated using the Polarus nail. In 14 cases the initial treatment was operative; the other 21 patients were initially treated nonoperatively. 19 patients had a 2-part fracture, 5 had a 3-part fracture and 2 had a 4-part fracture. In 9 patients the fracture extended metaphyseally. The functional outcome was assessed by the Constant score. RESULTS: 28 patients were available for 1-year followup. 17 patients showed excellent functional outcome (with an average Constant score of 81%). 6 patients required revision surgery, 1 because of nonunion and 1 because of an avascular necrosis. 4 others were reoperated because of inadequate position of the osteosynthesis or migration of the screws. INTERPRETATION: The Polarus nail is of value for (displaced) 2-, 3-, and even 4-part proximal humeral fractures and enables early postoperative mobilization with a limited amount of pain.