05 Originales 2591 (342-353)

Received: July 2005. Accepted: January 2006. Aim. To value the technical complications associated with Seidel’s intramedullary nailing using in the management of humeral diaphyseal fractures. Materials and methods. Retrospective study of 43 cases, controlled between the year 1999 and 2003, analyzing epidemiological, clinical-radilogical parameters, as well as the most frequent complications and the mobility of the shoulder. A whole of 35 cases was initial fractures and 8 pathological fractures for metastasis of primary tumors. The pseudoartrosis were excluded. The average of age of the initial fractures was 51.1 years, with 2 peaks at the age of 25-30 and at the age of 75-80. There were 7 exitus, 6 on pathological fractures. The nailing was always anterograde, the majority by means of sky closed and proximal and distal blocks. The average follow-up of the initial fractures was 144 days though in 6 cases it was insufficient to establish the consolidation. Results. The excessive length of the implant, damaging the blockade distal, was the principal complication (30.2%). The following ones were the procidencia proximal of the nail (25.5%), with limitation for the mobility, which there forced to remove the nail in 50% of the same ones and the problems in the blockade proximal (11.6%). In 29 cases of initial fractures that completed the study, the consolidation was achieved in 79.3% in 106.5 days of average, with good/excellent mobility in 65.1% in the moment in which this one became stable. Conclusions. Seidel’s nail are is useful in the treatment of selected fractures of the diaphyseal humerus, though the technical associate complications bear important limitations and a long billiard cue curls of learning. The new recently appeared implants can settle these difficulties.