The synthesis of trochanteric fractures has evolved considerably since the use of the Staca nail-plate in 1964. This implant, despite its age, remains a solid and reliable material for the synthesis of this type of fr...The synthesis of trochanteric fractures has evolved considerably since the use of the Staca nail-plate in 1964. This implant, despite its age, remains a solid and reliable material for the synthesis of this type of fracture. Objective: To evaluate the anatomo-clinical and functional results of Staca nail-plate osteosynthesis of trochanteric fractures at the Regional University Hospital of Ouahigouya in Burkina Faso. Methods: We performed a retrospective study of 52 trochanteric fractures treated by Staca nail-plate in the regional university hospital of Ouahigouya between June 2007 and June 2017. There were 10 women and 42 men with a mean age of 61 years (range 17 years to 89 years). Ten stable type I and II of Ender classification fractures and 42 unstable fractures were recorded, including four pseudarthrosis and six vicious calluses. The anterolateral approach was used in all cases. In the absence of an image intensifier, we performed an arthrotomy to identify the femoral neck and set up a guide pin. Results: The reduction was satisfactory with stable synthesis in 39 cases. At last follow-up, consolidation was effective in all patients, except one. Two cases of acetabular protrusion were noted, requiring early removal of equipment. Fifty-one patients were autonomous. The overall results were considered satisfactory. Conclusion: The Staca nail-plate remains a means of solid osteosynthesis. Although it is no longer relevant in industrialized countries, it provides comparable results to new implants for the osteosynthesis of trochanteric fractures. Because of its low cost, its abandonment is not justified in low-income countries.展开更多
Objective:Beau lines,onychorrhexis,and psoriatic lesions of the dorsal nail plate may be missed by photographic methods,indicating a need for surface texture measurement methods that are more quantitative,sensitive,an...Objective:Beau lines,onychorrhexis,and psoriatic lesions of the dorsal nail plate may be missed by photographic methods,indicating a need for surface texture measurement methods that are more quantitative,sensitive,and repeatable than visual inspection or imaging.We conducted this study to evaluate the utility of surface texture measurements of cadaveric nails that can be associated with histopathological studies in the future.Methods:The nail plates of 4 cadaveric right pollices and halluces were cleaned and molded,cast in clear epoxy,and scanned with a Sensofar S Neox optical profilometer.A one-way analysis of variance was performed to determine statistical significance of findings.Results:Almost no differences were observed between the pollex and hallux scans and between the distal and proximal regions.The greatest differences were found between individuals.Although lower magnification(5×)is less sensitive than higher magnification(20×),the lower magnification represented and characterized more of the dorsal nail plate.Conclusion:The dorsal nail plate areal roughness has a measurable range of values that may serve as a starting point for evaluating pathological findings,particularly Beau lines and psoriatic lesions.The sensitivity of these techniques may be especially valuable in the recognition of less severe states of these diseases that may enable the diagnosis of earlier stages of growth disruptions(Beau lines)or psoriasis.Such applications could be especially useful in investigations of the health of wildlife populations or vulnerable human populations with incomplete treatment records.展开更多
The nail plate forms a barrier that limits the effectiveness of drug delivery in the treatment of nail diseases and prevents the outflow of fluid in the case of subungual hematoma formation. Microperforation of the na...The nail plate forms a barrier that limits the effectiveness of drug delivery in the treatment of nail diseases and prevents the outflow of fluid in the case of subungual hematoma formation. Microperforation of the nail plate through laser radiation can increase the effectiveness of drug delivery and ensure the possibility of blood outflow. This study detected and identified the type and threshold of effects that arise from exposing the nail plate to Yb,Er： Glass （λ = 1.54 μm） and Er：YLF （λ= 2.81 μm） laser radiation. The rate and efficiency of nail plate ablation by the radiation of these lasers were studied. The effect of the storage time of a freshly extracted nail plate in open air on its ablation rate by Er：YLF （ λ=2.81 μm） laser radiation was also investigated. The impact of the Yb,Er：Glass and Er：YLF laser pulses on the nail plate caused bleaching, carbonization, ablation with microcrater formation, and microperforation. The laser energy densities WE （thresholds） required for these effects were determined. The maximum ablation rate for Yb,Er：Glass laser radiation was 8 μm/pulse at WE = 91 ±2 J/cm2, whereas that for Er：YLF laser radiation was 12 μm/ pulse at WE= 10.5＋0.5 J/cm2. The maximum ablation efficiency for Yb,Er：Glass laser radiation was 0.1 μm/mJ at Ws = 10.5±0.5 J/cm2, whereas that for Er：YLF laser radiation was 4.6 μm/mJ at WE = 5.3±0.3 J/cm2. The laser ablation rate depends on the storage time and conditions of the freshly extracted nail plate. For example, when exposed to Er：YLF laser radiation, the laser ablation rate decreased by half from the initial maximum value in 96 h of air storage and returned to the initial value after 1 h of storage in distilled water.展开更多
Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However...Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.展开更多
Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is...Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3<sup>rd</sup> of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.展开更多
An investigation into the pullout response of helical soil nail using finite element subroutine Plaxis 2D is presented.The numerical modelling of actual pullout response is achieved by axisymmetric and horizontal load...An investigation into the pullout response of helical soil nail using finite element subroutine Plaxis 2D is presented.The numerical modelling of actual pullout response is achieved by axisymmetric and horizontal loading condition.The effect of varying number of helical plates,helical plate spacing and helical plate diameter is studied to understand the pullout capacity behaviour.The failure surfaces for various helical soil nail configurations and their pullout mechanisms are also analysed and discussed.The pullout capacity is found to increase with increase in number of helical plates.The helical plate spacing ratio（s/D;） and diameter ratio（D;/D;） are found to increase the pullout only up to a critical value.The response of helical soil nail using axisymmetric finite element simulation is found similar to the uplift behaviour of helical piles and helical soil anchors.In the absence of literature regarding numerical modelling of helical soil nail,simulation results are validated with uplift responses of helical piles and soil anchors.A good agreement in their comparative study for pullout response is also observed.展开更多
In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable the...In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.展开更多
In proximal humeral fracture except AO classification 11A1, fixations with a locking plate and nails are recommended. We performed mechanical tests to investigate whether retrograde intramedullary nailing has fixation...In proximal humeral fracture except AO classification 11A1, fixations with a locking plate and nails are recommended. We performed mechanical tests to investigate whether retrograde intramedullary nailing has fixation stability comparable to those of anterograde intramedullary nailing and locking plate which achieve clinically favorable outcomes. In retrograde intramedullary nailing, a nail entry point is made in the diaphysis, for which reduction of stiffness of the humerus is of concern. Thus, we investigated the influence of a nail entry point made in the diaphysis on humeral strength. Retrograde intramedullary nailing had fixation stability against bending and a force loaded in the rotation direction comparable to those of anterograde intramedullary nail and locking plate. Displacement by the main external force loaded on the humerus, compressive load, was less than half in the bone fixed by retrograde intramedullary nailing compared with that in the bone fixed with a locking plate, showing favorable fixation stability. It was clarified that stiffness of the humerus against rotation and a load in the compression direction is not reduced by a nail entry point made by retrograde intramedullary nailing.展开更多
文摘The synthesis of trochanteric fractures has evolved considerably since the use of the Staca nail-plate in 1964. This implant, despite its age, remains a solid and reliable material for the synthesis of this type of fracture. Objective: To evaluate the anatomo-clinical and functional results of Staca nail-plate osteosynthesis of trochanteric fractures at the Regional University Hospital of Ouahigouya in Burkina Faso. Methods: We performed a retrospective study of 52 trochanteric fractures treated by Staca nail-plate in the regional university hospital of Ouahigouya between June 2007 and June 2017. There were 10 women and 42 men with a mean age of 61 years (range 17 years to 89 years). Ten stable type I and II of Ender classification fractures and 42 unstable fractures were recorded, including four pseudarthrosis and six vicious calluses. The anterolateral approach was used in all cases. In the absence of an image intensifier, we performed an arthrotomy to identify the femoral neck and set up a guide pin. Results: The reduction was satisfactory with stable synthesis in 39 cases. At last follow-up, consolidation was effective in all patients, except one. Two cases of acetabular protrusion were noted, requiring early removal of equipment. Fifty-one patients were autonomous. The overall results were considered satisfactory. Conclusion: The Staca nail-plate remains a means of solid osteosynthesis. Although it is no longer relevant in industrialized countries, it provides comparable results to new implants for the osteosynthesis of trochanteric fractures. Because of its low cost, its abandonment is not justified in low-income countries.
文摘Objective:Beau lines,onychorrhexis,and psoriatic lesions of the dorsal nail plate may be missed by photographic methods,indicating a need for surface texture measurement methods that are more quantitative,sensitive,and repeatable than visual inspection or imaging.We conducted this study to evaluate the utility of surface texture measurements of cadaveric nails that can be associated with histopathological studies in the future.Methods:The nail plates of 4 cadaveric right pollices and halluces were cleaned and molded,cast in clear epoxy,and scanned with a Sensofar S Neox optical profilometer.A one-way analysis of variance was performed to determine statistical significance of findings.Results:Almost no differences were observed between the pollex and hallux scans and between the distal and proximal regions.The greatest differences were found between individuals.Although lower magnification(5×)is less sensitive than higher magnification(20×),the lower magnification represented and characterized more of the dorsal nail plate.Conclusion:The dorsal nail plate areal roughness has a measurable range of values that may serve as a starting point for evaluating pathological findings,particularly Beau lines and psoriatic lesions.The sensitivity of these techniques may be especially valuable in the recognition of less severe states of these diseases that may enable the diagnosis of earlier stages of growth disruptions(Beau lines)or psoriasis.Such applications could be especially useful in investigations of the health of wildlife populations or vulnerable human populations with incomplete treatment records.
文摘The nail plate forms a barrier that limits the effectiveness of drug delivery in the treatment of nail diseases and prevents the outflow of fluid in the case of subungual hematoma formation. Microperforation of the nail plate through laser radiation can increase the effectiveness of drug delivery and ensure the possibility of blood outflow. This study detected and identified the type and threshold of effects that arise from exposing the nail plate to Yb,Er： Glass （λ = 1.54 μm） and Er：YLF （λ= 2.81 μm） laser radiation. The rate and efficiency of nail plate ablation by the radiation of these lasers were studied. The effect of the storage time of a freshly extracted nail plate in open air on its ablation rate by Er：YLF （ λ=2.81 μm） laser radiation was also investigated. The impact of the Yb,Er：Glass and Er：YLF laser pulses on the nail plate caused bleaching, carbonization, ablation with microcrater formation, and microperforation. The laser energy densities WE （thresholds） required for these effects were determined. The maximum ablation rate for Yb,Er：Glass laser radiation was 8 μm/pulse at WE = 91 ±2 J/cm2, whereas that for Er：YLF laser radiation was 12 μm/ pulse at WE= 10.5＋0.5 J/cm2. The maximum ablation efficiency for Yb,Er：Glass laser radiation was 0.1 μm/mJ at Ws = 10.5±0.5 J/cm2, whereas that for Er：YLF laser radiation was 4.6 μm/mJ at WE = 5.3±0.3 J/cm2. The laser ablation rate depends on the storage time and conditions of the freshly extracted nail plate. For example, when exposed to Er：YLF laser radiation, the laser ablation rate decreased by half from the initial maximum value in 96 h of air storage and returned to the initial value after 1 h of storage in distilled water.
文摘Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.
文摘Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3<sup>rd</sup> of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.
文摘An investigation into the pullout response of helical soil nail using finite element subroutine Plaxis 2D is presented.The numerical modelling of actual pullout response is achieved by axisymmetric and horizontal loading condition.The effect of varying number of helical plates,helical plate spacing and helical plate diameter is studied to understand the pullout capacity behaviour.The failure surfaces for various helical soil nail configurations and their pullout mechanisms are also analysed and discussed.The pullout capacity is found to increase with increase in number of helical plates.The helical plate spacing ratio（s/D;） and diameter ratio（D;/D;） are found to increase the pullout only up to a critical value.The response of helical soil nail using axisymmetric finite element simulation is found similar to the uplift behaviour of helical piles and helical soil anchors.In the absence of literature regarding numerical modelling of helical soil nail,simulation results are validated with uplift responses of helical piles and soil anchors.A good agreement in their comparative study for pullout response is also observed.
文摘In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.
文摘In proximal humeral fracture except AO classification 11A1, fixations with a locking plate and nails are recommended. We performed mechanical tests to investigate whether retrograde intramedullary nailing has fixation stability comparable to those of anterograde intramedullary nailing and locking plate which achieve clinically favorable outcomes. In retrograde intramedullary nailing, a nail entry point is made in the diaphysis, for which reduction of stiffness of the humerus is of concern. Thus, we investigated the influence of a nail entry point made in the diaphysis on humeral strength. Retrograde intramedullary nailing had fixation stability against bending and a force loaded in the rotation direction comparable to those of anterograde intramedullary nail and locking plate. Displacement by the main external force loaded on the humerus, compressive load, was less than half in the bone fixed by retrograde intramedullary nailing compared with that in the bone fixed with a locking plate, showing favorable fixation stability. It was clarified that stiffness of the humerus against rotation and a load in the compression direction is not reduced by a nail entry point made by retrograde intramedullary nailing.
