Table 5.
Review of all studies (215 patients) reporting on the use of Polarus nail for proximal humeral fractures
| Author/Year | N of pts | Mean Age(years) | Fracture type:N of pts | F.U.(months) | Union rate | Time to union | Functional outcome(Score/mean) | Complications(rate) |
|---|---|---|---|---|---|---|---|---|
| Georgousis [15] 2010 |
24 |
60 |
3-part: 13 |
12 |
100% |
9.2 weeks |
Constant score: |
1 asymptomatic malunion |
| 4-part: 7 |
(1 delayed union that healed) |
- 8 pts: 90% (excellent) |
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| 3-/4-part |
−12 pts: 83% (good) |
1 iatrogenic radial nerve palsy |
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| + shaft: 4 |
- 3pts: 63% (moderate) |
2 nail impingement |
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| −1 pt: 54% (poor) |
(nail removal) (16.7%) |
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| Sforzo [19] 2009 |
14 |
56 |
2-part: 7 |
40 |
100% |
12 weeks |
SPADI: 30 (good) |
2 malunions |
| 3-part: 5 |
Excellent: 6 |
(1 retroversion, 1 lesser tuberosity) |
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| 4-part: 2 |
Good: 2 |
1 shoulder stiffness & postop complex regional pain syndrome |
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| Fair: 3 |
1 loosening of proximal screw (removal) (28.6%) |
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| Poor: 1 (2 unknown) |
|
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| Koike [17] 2008 |
54 |
66 |
2-part: 29 |
18 |
100% |
Max. 24 months |
JOA score: 81 points |
1 superficial infection |
| 3-part: 22 |
- 79% satisfactory to excellent |
4 loosening of proximal screws (7%) |
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| 4-part: 3 |
- 21% unsatisfactory results |
(3 removed, 1 nail removed) |
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| residual deformities (16%) (9.3%) | ||||||||
| Kazakos [16] 2007 |
27 |
65.9 |
2-part: 16 |
12 |
100% |
Time to sufficient bridging callus on X-rays: 6 weeks |
Neer score: |
1 screw back-out |
| 3-part: 11 |
−6 pts 93.3 |
1 shoulder stiffness |
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| 4-part: 0 |
−15 pts 85.4 |
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| −4 pts 73.5 |
1 AVN of humeral head (11.1%) |
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| −2 pts 62.5 | ||||||||
| Sosef [20] 2007 |
28 |
66 |
2-part: 16 |
12 |
96.4% |
not reported |
Constant score: 81% |
1 non-union |
| 3-part: 4 |
-17pts: >75% |
1 AVN of humeral head |
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| 4-part: 2 |
-8pts: 50-75% |
4 removal of all or parts of the fixation |
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| (Metaphyseal extension: 6) |
-3pts:<50% |
(screw migration into the glenohumeral Joint or impingement) |
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| 3 proximal screw back-out (32.1%) | ||||||||
| Agel [14] 2004 |
20 |
48 |
2-part: 16 |
10 |
65% |
not reported |
13 (65%) healed (1 pt died at 5 months with a delayed union) |
1 superficial infection |
| 3-part: 3 |
−6 were not healed at the time of the last follow-up |
1 proximal screw migration into the glenohumeral |
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| 4-part: 1 |
3 proximal screws loosened |
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| 2 fixation failure (1 revision, 1 healed in varus) | ||||||||
| 7 delayed/non-union (70%) | ||||||||
| Adedapo [10] 2001 |
23 |
68.7 |
3-part:10 |
12 |
- |
not reported |
Neer score (median): |
3 proximal screw loosening & back-out |
| 4-part: 6 |
−3-part: 89 |
1 AVN of humeral head (17.4%) |
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| 3-/4-part |
−4-part: 60 |
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| + shaft: 7 |
−3 or 4-part + shaft: 73 |
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| Constant score (median): | ||||||||
| −3-part: 91.5% | ||||||||
| −4-part: 67% | ||||||||
| −3 or 4-part + shaft: 71% | ||||||||
| Rajasekhar [18] 2001 | 25* | 71 (F) |
2-part: 23 |
18 | 96% | not reported | Constant score |
1 non-union |
| 53 (M) | 3-part: 4 |
-13pts: >75% |
1 shoulder stiffness |
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| (**: 3) | -7pts: 50-75% |
1 AVN of humeral head |
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| -5pts<50% | 1 proximal screw back-out (16%) |
(M: male, F: female, *: initially 30pts, **: not classified).