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Table 5 Review of all studies (215 patients) reporting on the use of Polarus nail for proximal humeral fractures

From: “Internal fixation of proximal humeral fractures using the Polarus intramedullary nail: our institutional experience and review of the literature”

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%)
  1. (M: male, F: female, *: initially 30pts, **: not classified).