Can the complications of distal locking be prevented with a new nail that offers a novel locking technique in the treatment of humeral shaft fractures?

OBJECTIVES: This study aims to investigate whether complications related to distal locking can be prevented with InSafeLOCK® nail in the treatment of humeral shaft fractures. PATIENTS AND METHODS: Hospital records of 31 patients (15 males, 16 females; mean age 54.4±10.1 years; range, 20 to 86 years) treated with InSafeLOCK® nail for humeral shaft fractures were investigated retrospectively between February 2016 and January 2019. AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification was used to determine the type of fracture. During the implementation, the elapsed time for distal locking was investigated. Complications encountered during both implementation and postoperative follow-up were investigated. RESULTS: Fourteen of the fractures were type A, 12 were type B, and five were type C. The mean follow-up time was 18.2 (range, 6 to 30.5) months. The mean duration for distal locking was 2.1 (range, 1.2 to 3.1) minutes. In one (3.2%) patient, cortical penetration occurred at the anterior cortex of the humerus at distal to the nail. In one patient, nail breakage occurred at the distal part of the nail. In one patient, rotational instability occurred due to screw loosening. CONCLUSION: InSafeLOCK® humeral nail is safe when applied with the recommended technique. It can easily be applied without damaging the veins, nerves or other soft tissues around the elbow due to the internal distal locking feature; furthermore, there is no need to use fluoroscopy or targeting guide. Thus, it is possible to avoid complications that may occur during and after distal locking in conventional intramedullary nail implementations.