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humeral
The indications for primary arthroplasty included: humeral head fracture (20), osteoarthritis (14), posttraumatic avascular head necrosis (11), cuff tear arthropathy (6) and rheumatoid arthritis (1).
      
Intraoperatively, disorders were identified and attributed to pathology present on the humeral side related to bone loss or failure (38 %), soft tissue injury (29 %), implant failure (21%) or infection (12 %).
      
On the humeral side good outcomes resulted in cases that were revised for implant failures.
      
We report about our experience using elastic stable intramedullary nailing for markedly displaced proximal humeral fractures Type III and IV in children.
      
The following complications occurred: one nail perforated the humeral head, one nail was placed in the wrong position, two problems occurred with the removal of the nail.
      
In 31% of the patients an unstable type was found with only minimal radiological changes of the humeral head (HH).
      
In summary, proximal humeral nails offer a less invasive treatment of even complex proximal humeral fractures with high primary stability.
      
Suggestion for a Modular Topographic-Morphologic Classification of Proximal Humeral Fractures
      
Treatment of a Humeral Metastasis with a Composite Allograft-Prosthetic Reconstruction
      
The simultaneous occurrence of ipsilateral humeral supracondylar,
      
Intramedullary Nailing of Humeral Head and Humeral Shaft Fractures
      
There is an increasing interest in intramedullary nailing for humeral fractures.
      
Basic ideas for humeral nailing are less invasive approaches to the humerus, less soft tissue damage, e.g.
      
Nailing of distal metaphyseal humeral fractures is no serious option at the moment.
      
Improved imaging, updated knowledge regarding humeral head perfusion and adapted fixation techniques with implants having better purchase also in osteopenic bone, have influenced the treatment of proximal humeral fractures in recent years.
      
Long-term morbidity related to the treatment of these fractures like avascular humeral head necrosis, non-union, malunion, shoulder stiffness, persistent pain and functional disability are the challenging factors to be overcome.
      
Even though plating of proximal humeral fractures with angular stable implants has shown promising first clinical results, there still remain elevated complication rates especially in the elderly osteoporotic patient population.
      
Arthroscopical Findings after Antegrade Nailing of a Proximal Humeral Fracture
      
Proximal humeral fractures represent up to five percent of all fractures in adults, commonly found in elderly patients.
      
In our institution antegrade intramedullary nailing is the treatment of choice for proximal humeral fractures.
      
 

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