• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.169-175
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• 2006

Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.87-92
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• 2019

Background: This study was conducted to compare the radiological and clinical outcomes of internal fixation using a Polarus humeral nail for treatment of a humeral shaft fracture according to fracture types. Methods: From 43 patients, 13 were excluded and 30 patients were included. The 30 patients were divided into 2 groups: 15 in group I (Orthopaedic Trauma Association/Arbeitsgemeinschaft $f{\ddot{u}}r$ Osteosynthesefragen classification type A and B) and 15 in group II (type C). The mean age was 63.1 years (range, 20-87 years), and mean follow-up period was 2.3 years (range, 1.0-6.1 years). The causes of injuries were as follows: 12, traffic accidents; 14, simple slips; 2, simple falls; 2, contusions after lower energy trauma. Radiological and clinical evaluations were performed. Results: Radiological union was confirmed by plain anteroposterior and lateral radiographs on average of 5.0 months in group I, and 8.4 months in group II, respectively. Differences between the two groups were statistically significant (p<0.01). The clinical union value was 1.6 in group I, and 2.0 months in group II, but these values did not differ significantly (p=0.441). The mean Korean shoulder scoring system scores were 89.7 and 90.6, which did not differ significantly (p=0.352). Conclusions: Intramedullary nailing using the Polarus humeral nail is considered to be a good treatment modality for all types of humeral shaft fractures. Additionally, the Polarus humeral nail can be an optimal choice for the treatment of complex type fractures such as segmental or comminuted humeral shaft fractures.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.112-123
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• 2007

목적: 상완골 경부의 불유합에 대한 치료로 Polarus 골수정을 이용한 수술적 치료 방법의 임상적, 방사선학적 치료 결과를 알아보고자 하였다. 대상 및 방법: 상완골 외과적 경부골절의 불유합으로 수술적 치료를 받은 환자 8명을 대상으로 하였다. 모두 여성 환자였으며, 평균 연령은 65세였다. 8예 중 5예는 1차 수술적 치료후 불유합 환자로 1차적 치료로는 관혈적 정복술 후 금속판 내고정 1예, Ender 정 삽입 2예, 외고정 1예 및 도수 정복술 후 경피적 핀 고정 1예였으며, 3예는 보존적 치료 후의 불유합 환자였다. 불유합 기간은 1차적 수술을 받은 환자군에서 약 9개월(범위 $3.5{\sim}14.8$개월), 수술을 받지 않았던 환자군에서 6.2개월(범위 $3{\sim}7.8$개월)이었다. 수술적 치료로는 8예 모두에서 Polarus 골수정을 이용한 내고정 및 자가장골 이식술을 시행하였다. 골유합은 방사선학적 소견으로 판정하였으며, 기능적 평가는 University of california at Los Angeles(UCLA) 견관절 평가 지수를 사용하였다. 결과: 8례 모두에서 방사선학적 골유합을 얻었다. 골유합까지의 평균 기간은 3.5개월이었으며, 평균 추시 기간은 27개월이었다. UCLA 견관절 평가지수는 수술 전 평균 7.6(범위 $6{\sim}9$)점에서 수술 후 평균 26.3(범위 $10{\sim}33$)점으로 향상되었으며, 견관절의 능동적 굴곡은 수술 전 40.7도(범위 $20{\sim}60$도)에서 수술 후 104도(범위 $50{\sim}160$도)로 증가하였으며, 견관절의 능동적 외전은 수술 전 32.9도(범위 $20{\sim}60$도)에서 수술 후 96.3도(범위 $60{\sim}120$도)로 역시 증가하였다. UCLA functional criteria는 양호(Good) 5예, 보통(Fair) 3예였으며, 불량(poor)에 해당하는 환자는 없었다. 결론: 고령 환자의 상완골 경부 불유합의 치료로서 Polarus 골수정 및 자가장골 이식술을 이용한 내고정술은 골유합과 기능의 향상에 있어 유용한 치료방법으로 생각된다.