Retrograde intramedullary nailing for humeral midshaft fractures : a retrospective cohort study


Humeral midshaft fracture ; intramedullary nailing, retrograde ; operative complications ; patient reported outcome measurement ; DASH

Published online: Feb 13 2021

Femke Nawijn, Jort Keizer, Laurien Waaijer, Willem-Maarten PF Bosman, Philippe Wittich, Benjamin L. Emmink

From the St Antonius Hospital, Department of Surgery, Utrecht, The Netherlands


This study evaluates the patient-reported functional outcome, clinical functional outcome and frequency of complications of simple oblique and transverse humeral midshaft fractures treated with a retrograde expert humeral nail.

A retrospective cohort study of humeral midshaft fractures (AO 12-A2, 12-A3) treated with retrograde nailing between January 2010 and February 2018 in a level II trauma center was performed. Patients’ perception of functional outcome was measured using the Disabilities of the Arm, Shoulder and Hand (DASH) scores.

Thirteen patients with a median age of 20-years were treated with a retrograde nail. The median DASH score, administered 29 months (IQR 74) after surgery, was 7.9 (IQR 15.9). There were no perioperative frac- tures and the frequency of complications was 8%, being one nonunion.

Retrograde nailing for humeral midshaft fractures is a safe technique, with excellent patient reported and clinical functional outcome. No iatrogenic peri- operative fractures occurred and the frequency of complications was low. We recommend the retrograde technique, if surgical fixation of humeral midshaft fractures is needed, especially in younger patients for who rotator cuff associated injuries will have a major impact on quality of life.