Intramedullary Nailing in Proximal Humerus Fractures: Functional and Radiological Outcomes in a Prospective Indian Cohort

Introduction: Proximal humerus fractures constitute a substantial proportion of upper limb injuries, particularly in elderly individuals and increasingly in younger patients following high-energy trauma. Management of displaced fractures remains controversial, with multiple operative modalities including locking plates, intramedullary nails, and arthroplasty. Intramedullary nailing (IMN) has evolved with improved designs that allow stable fixation, minimal soft-tissue disruption, and early mobilization.

Aim: To evaluate the functional and radiological outcomes of proximal humerus fractures treated with intramedullary nailing.

Methodology: A prospective observational study was conducted on 50 patients with displaced proximal humerus fractures treated with intramedullary nailing at a tertiary care teaching hospital in India. Patients were followed for a minimum period of 12 months. Clinical outcomes were assessed using the Constant–Murley Score and Visual Analogue Scale (VAS) for pain, while radiological union and complications were documented.

Results: The mean age of patients was 54.6 ± 13.2 years. Two-part fractures were the most common (52%), followed by three-part fractures (34%) and four-part fractures (14%). Radiological union was achieved in 94% of cases by 16 weeks. Excellent to good functional outcomes were observed in 82% of patients. Complications occurred in 18% of cases, with shoulder impingement and screw migration being the most frequent.

Conclusion: Intramedullary nailing provides reliable fracture union with satisfactory functional outcomes and acceptable complication rates in displaced proximal humerus fractures, making it a valuable option in appropriately selected patients.