Single-centre case series of 41 patients treated with a modified locked IM nail (shortened 9 mm Grosse-Kempf tibial nail) for humeral shaft fractures, nonunions, and pathological fractures. Compares antegrade shoulder insertion (n=11) vs. retrograde olecranon fossa insertion (n=30) and describes implant design rationale, operative technique, and union outcomes.
When planning IM nailing of mid- or distal-third humeral shaft fractures, prefer retrograde insertion through the olecranon fossa over antegrade shoulder entry — shoulder morbidity is substantially reduced and patients with ipsilateral lower-limb injuries can bear weight on crutches within two weeks.
Always lock both ends statically; the only union failure in this series was the one nail locked at a single end.
Single-centre case series of 41 patients treated with a modified locked IM nail (shortened 9 mm Grosse-Kempf tibial nail) for humeral shaft fractures, nonunions, and pathological fractures. Compares antegrade shoulder insertion (n=11) vs. retrograde olecranon fossa insertion (n=30) and describes implant design rationale, operative technique, and union outcomes.
When planning IM nailing of mid- or distal-third humeral shaft fractures, prefer retrograde insertion through the olecranon fossa over antegrade shoulder entry — shoulder morbidity is substantially reduced and patients with ipsilateral lower-limb injuries can bear weight on crutches within two weeks.
Always lock both ends statically; the only union failure in this series was the one nail locked at a single end.