Ender nail fixation of humeral diaphyseal fracture: Indications and outcome – A series of 46 cases

Objectives To evaluate the clinical and functional results of closed fixation of humeral diaphysial fractures using Ender nails. Material and methods This was an observational study conducted between January 2008 and September 2014 in which 46 cases of humeral diaphyseal fractures were treated by closed reduction and percutaneous fixation with Enders nails. Clinical follow up evaluation was done and Serial radiographs were taken to look for the time taken for the fracture union and the fracture alignment, positioning and migration of the nails if any. Results Average blood loss during the surgery was 30 ml while average radiation exposure time was 1 min. Fracture united in mean 12.8 weeks (range 12-28 weeks). Primary union was achieved in 40 cases, whereas 6 had delayed union at 24 weeks for which autogenous bone grafting was done. Proximal migration of nails occurred in 6 cases and 3 cases had superficial stitch infection. Full range of shoulder and elbow movement was achieved in 40 cases within 24 weeks. In rest of the cases, there was limitation of abduction (average 75°, Range 65° to 85°). Conclusion Ender nailing for fracture shaft of humerus is a cost effective, time saving, minimally invasive technique with minimal blood loss. It has many benefits, with good results attainable and comparable with those seen with conservative modalities and other surgical modalities making it a viable option.