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) | ||||||
3-/4-part | −12 pts: 83% (good) | 1 iatrogenic radial nerve palsy | ||||||
+ shaft: 4 | - 3pts: 63% (moderate) | 2 nail impingement | ||||||
−1 pt: 54% (poor) | (nail removal) (16.7%) | |||||||
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) | ||||||
4-part: 2 | Good: 2 | 1 shoulder stiffness & postop complex regional pain syndrome | ||||||
Fair: 3 | 1 loosening of proximal screw (removal) (28.6%) | |||||||
Poor: 1 (2 unknown) | ||||||||
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%) | ||||||
4-part: 3 | - 21% unsatisfactory results | (3 removed, 1 nail removed) | ||||||
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 | ||||||
4-part: 0 | −15 pts 85.4 | |||||||
−4 pts 73.5 | 1 AVN of humeral head (11.1%) | |||||||
−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 | ||||||
4-part: 2 | -8pts: 50-75% | 4 removal of all or parts of the fixation | ||||||
(Metaphyseal extension: 6) | -3pts:<50% | (screw migration into the glenohumeral Joint or impingement) | ||||||
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 | ||||||
4-part: 1 | 3 proximal screws loosened | |||||||
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%) | ||||||
3-/4-part | −4-part: 60 | |||||||
+ shaft: 7 | −3 or 4-part + shaft: 73 | |||||||
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 | |||||
(**: 3) | -7pts: 50-75% | 1 AVN of humeral head | ||||||
-5pts<50% | 1 proximal screw back-out (16%) |