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Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Obruba, Petr ; Džupa, Valér (advisor) ; Horák, Zdeněk (referee) ; Paša, Libor (referee)
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...
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