[Treatment of humeral fractures by Marchetti nailing. Apropos of 45 cases]

Abstract

Between 1995 and 1997 we implanted 45 Marchetti nails. These nails were implanted for traumatic fractures in 39 patients, but also for pathologic fractures in 5 patients. Among these 39 patients, 7 were lost of view, the average age was 60 years. Among these 39 patients, 4 have got an other treatment before which failed. 10 fractures were placed D1, 8 fractures placed D2, 5 fractures placed D3, 16 fractures placed D4 according to the classification of Hackethal modified by De la Caffinière. The fracture type was classified according to A. O. classification: 7 A1, 11 A2, 7 A3, 2 B1, 6 B2, 1 B3, 4 C1, 1 C2. Among the 32 patients reviewed with an average of follow-up of 11 months, we have observed 5 very good results, 14 good results, 6 passable results and 3 bad results (classification of Stewart and Hundley). The average length of consolidation was 3 months. At follow-up the average elbow mobility was 129 degrees. Among the 3 bad results, there were 2 pseudarthrosis, in D4 zone. We have got 3 supracondylar fractures during the removal of the nail and 2 impactions of the metaphysis fracture. 5 patients had a nailing for pathologic fractures, one of them bilateral (4 women and one man, average age 65 years). Only two patients were reviewed, the fracture healed without any difference with the traumatic group. Contrary to other nailing, this materiel respects the rotator cuff. The global functional result was good.