Diaphyseal Fractures of the Humerus Treated With the MultiLoc® Nail: Mid-Term Results
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Published:
Dec 27, 2025
Keywords:
Humeral fracture, diaphyseal, intramedullary nail, osteosynthesis
Main Article Content
Abstract
Introduction: Several satisfactory therapeutic options exist for diaphyseal humeral fractures. The MultiLoc® humeral intramedul-lary nail is a straight implant that offers multiple proximal locking configurations. The type and extent of proximal locking can be adapted to the fracture pattern and to more complex biomechanical requirements.
Objective: To describe the radiographic and clinical-functional outcomes of patients with diaphyseal humeral fractures treated with a straight MultiLoc® intramedullary nail, along with associated complications and their management.
Materials and Methods: Sixty-four patients with AO type 1.2 hu-meral fractures treated with a MultiLoc® nail and with a minimum clinical and radiographic follow-up of 18 months were included. Variables analyzed included clinical progression using the DASH score, return to pre-injury activity, and radiographic evaluation.
Results: The mean DASH score after more than 18 months was 41. The average time to return to pre-injury activity was 3.1 months. Nine patients reported pain at the nail entry site; in seven cases, pain resolved with rehabilitation, while the remaining two presented proximal nail protrusion that required implant removal after fracture consolidation. The consolidation rate was 96.87%.
Conclusion: The use of straight nails with angular stability in diaphyseal humeral fractures yields excellent mid-term clinical and radiographic outcomes.
Objective: To describe the radiographic and clinical-functional outcomes of patients with diaphyseal humeral fractures treated with a straight MultiLoc® intramedullary nail, along with associated complications and their management.
Materials and Methods: Sixty-four patients with AO type 1.2 hu-meral fractures treated with a MultiLoc® nail and with a minimum clinical and radiographic follow-up of 18 months were included. Variables analyzed included clinical progression using the DASH score, return to pre-injury activity, and radiographic evaluation.
Results: The mean DASH score after more than 18 months was 41. The average time to return to pre-injury activity was 3.1 months. Nine patients reported pain at the nail entry site; in seven cases, pain resolved with rehabilitation, while the remaining two presented proximal nail protrusion that required implant removal after fracture consolidation. The consolidation rate was 96.87%.
Conclusion: The use of straight nails with angular stability in diaphyseal humeral fractures yields excellent mid-term clinical and radiographic outcomes.
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How to Cite
Zublin, M., Beatti, M., Guichet, D., Pellecchia, T., & Arzac Ulla, I. (2025). Diaphyseal Fractures of the Humerus Treated With the MultiLoc® Nail: Mid-Term Results. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 90(6), 538-546. https://doi.org/10.15417/issn.1852-7434.2025.90.6.2222
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Clinical Research
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References
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https://doi.org/10.1016/j.injury.2006.04.130
2. Belangero WD, Zublin CM, Martinez Siekavizza SN, Sánchez Rosenberg GF, Cardenas Quintero RA, Azi ML, et al. Demographics and clinical features of humeral shaft fractures: The Latin American multicentre prospective study (HSF-LAMPS). J Orthop Surg (Hong Kong) 2019;27(3):2309499019874506. https://doi.org/10.1177/2309499019874506
3. Mocini F, Rovere G, De Mauro D, Giovannetti De Sanctis E, Smakaj A, Maccauro G, et al. Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term. J Orthop Surg Res 2021;16:631. https://doi.org/10.1186/s13018-021-02776-w
4. Qiu H, Liu Y, Chen Y, Weng Z, Liu D, Dong J, et al. Treatment of humeral shaft fractures with different treatment methods: a network meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2023;24(1):583. https://doi.org/10.1186/s12891-023-06626-0
5. Belangero W, Zublin C, Quintero R, Romero F, Fernandes H, Siekavizza S, et al. Quick-DASH as a main early outcome of humeral shaft fractures: A Latin American multicenter prospective study. J Orthop Surg (Hong Kong) 2020;28(2):2309499020929436. https://doi.org/10.1177/2309499020929436
6. Hessmann MH, Nijs S, Mittlmeier T, Kloub M, Segers MJM, Winkelbach V. Internal fixation of fractures of the proximal humerus with the MultiLoc nail. Oper Orthop Traumatol 2012;24:418-31. https://doi.org/10.1007/s00064-011-0085-z
7. Lopiz Y, Garcia-Coiradas J, Garcia-Fernandez C, Marco F. Proximal humerus nailing: a randomized clinical trial between curvilinear and straight nails. J Shoulder Elbow Surg 2014;23(3):369-76. https://doi.org/10.1016/j.jse.2013.08.023
8. Amer KM, Kurland AM, Smith B, Abdo Z, Amer R, Vosbikian MM, et al. Intramedullary nailing versus plate fixation for humeral shaft fractures: A systematic review and meta-analysis. Arch Bone Jt Surg 2022;10(8):661-7. https://doi.org/10.22038/ABJS.2021.59413.2947
9. Lopiz Y, Garriguez-Pérez D, Román-Gómez J, Scarano-Pereira JP, Ponz-Lueza V, García-Fernandez C, et al. Shoulder problems after percutaneous antegrade intramedullary nailing in humeral diaphyseal fractures using contemporary straight third-generation nail. J Shoulder Elbow Surg 2023;32(11):2317-24. https://doi.org/10.1016/j.jse.2023.04.012
10. Nadeem A, Abbasi H. Outcomes of intramedullary nailing versus plate fixation in the management of humeral shaft fractures: A systematic review and meta-analysis. Cureus 2024;27;16(10):e72473.
https://doi.org/10.7759/cureus.72473
11. Dilisio M, Nowinski R, Hatzidakis A, Fehringer E. Intramedullary nailing of the proximal humerus: evolution, technique, and results. J Shoulder Elbow Surg 2016;25:e130-8. https://doi.org/10.1016/j.jse.2015.11.016
12. Farragos AF, Schemitsch EH, McKee MD. Complications of intramedullary nailing for fractures of the humeral
shaft: a review. J Orthop Trauma 1999;13(4):258-67. https://doi.org/10.1097/00005131-199905000-00006
https://doi.org/10.1016/j.injury.2006.04.130
2. Belangero WD, Zublin CM, Martinez Siekavizza SN, Sánchez Rosenberg GF, Cardenas Quintero RA, Azi ML, et al. Demographics and clinical features of humeral shaft fractures: The Latin American multicentre prospective study (HSF-LAMPS). J Orthop Surg (Hong Kong) 2019;27(3):2309499019874506. https://doi.org/10.1177/2309499019874506
3. Mocini F, Rovere G, De Mauro D, Giovannetti De Sanctis E, Smakaj A, Maccauro G, et al. Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term. J Orthop Surg Res 2021;16:631. https://doi.org/10.1186/s13018-021-02776-w
4. Qiu H, Liu Y, Chen Y, Weng Z, Liu D, Dong J, et al. Treatment of humeral shaft fractures with different treatment methods: a network meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2023;24(1):583. https://doi.org/10.1186/s12891-023-06626-0
5. Belangero W, Zublin C, Quintero R, Romero F, Fernandes H, Siekavizza S, et al. Quick-DASH as a main early outcome of humeral shaft fractures: A Latin American multicenter prospective study. J Orthop Surg (Hong Kong) 2020;28(2):2309499020929436. https://doi.org/10.1177/2309499020929436
6. Hessmann MH, Nijs S, Mittlmeier T, Kloub M, Segers MJM, Winkelbach V. Internal fixation of fractures of the proximal humerus with the MultiLoc nail. Oper Orthop Traumatol 2012;24:418-31. https://doi.org/10.1007/s00064-011-0085-z
7. Lopiz Y, Garcia-Coiradas J, Garcia-Fernandez C, Marco F. Proximal humerus nailing: a randomized clinical trial between curvilinear and straight nails. J Shoulder Elbow Surg 2014;23(3):369-76. https://doi.org/10.1016/j.jse.2013.08.023
8. Amer KM, Kurland AM, Smith B, Abdo Z, Amer R, Vosbikian MM, et al. Intramedullary nailing versus plate fixation for humeral shaft fractures: A systematic review and meta-analysis. Arch Bone Jt Surg 2022;10(8):661-7. https://doi.org/10.22038/ABJS.2021.59413.2947
9. Lopiz Y, Garriguez-Pérez D, Román-Gómez J, Scarano-Pereira JP, Ponz-Lueza V, García-Fernandez C, et al. Shoulder problems after percutaneous antegrade intramedullary nailing in humeral diaphyseal fractures using contemporary straight third-generation nail. J Shoulder Elbow Surg 2023;32(11):2317-24. https://doi.org/10.1016/j.jse.2023.04.012
10. Nadeem A, Abbasi H. Outcomes of intramedullary nailing versus plate fixation in the management of humeral shaft fractures: A systematic review and meta-analysis. Cureus 2024;27;16(10):e72473.
https://doi.org/10.7759/cureus.72473
11. Dilisio M, Nowinski R, Hatzidakis A, Fehringer E. Intramedullary nailing of the proximal humerus: evolution, technique, and results. J Shoulder Elbow Surg 2016;25:e130-8. https://doi.org/10.1016/j.jse.2015.11.016
12. Farragos AF, Schemitsch EH, McKee MD. Complications of intramedullary nailing for fractures of the humeral
shaft: a review. J Orthop Trauma 1999;13(4):258-67. https://doi.org/10.1097/00005131-199905000-00006