Data on the effectiveness of arthroscopic arthrolysis and extraction of osteosynthetic material after osteosynthesis of the proximal humerus in patients with persisting problems are rare and insufficient. In this study, we performed arthroscopic arthrolysis and extraction of fixation screws, and, where protruding, extraction of the nail in 34 patients with problems persisting 12 months after osteosynthesis of the proximal humerus using an intramedullary nail. The effectiveness of the treatment was assessed using the Constant-Murley shoulder score and forward flexion difference between the treated arm and the contralateral one. A median increase of 16 points in CMS score and 30 degrees reduction in the arm forward flexion difference was recorded 12 months after the arthroscopy. The improvement was significantly higher in the patient group with intramedullary nail extraction (however, this group had worse pre-operative values and the screw was only extracted where likely to cause problems). The median time to heal was 11 weeks; no serious peri- or post-procedural complications occurred. Mini-invasive arthroscopic arthrolysis combined with extraction of osteosynthetic material proved to be a safe and effective method for treatment of patients after osteosynthesis of the proximal humerus using an intramedullary nail with persisting pain and/or mobility limitation.

Center for Health Research Faculty of Medicine University of Ostrava Syllabova 19 703 00 Ostrava Czech Republic

Centre for Advanced Innovation Technologies VŠB Technical University of Ostrava 708 33 Ostrava Czech Republic

Department of Applied Mathematics Faculty of Electrical Engineering and Computer Science VSB Technical University of Ostrava 708 00 Ostrava Czech Republic

Department of Orthopedics St Luke's Hospital Bielsko Biała Bystrzańska 94b str 43 300 Bielsko Biała Poland

Department of the Deputy Director for Science and Research University Hospital Ostrava 17 Listopadu 1790 708 52 Ostrava Czech Republic

Department of Trauma Surgery University Hospital Ostrava 17 Listopadu 1790 708 52 Ostrava Czech Republic

Faculty of Medicine Institute of Emergency Medicine University of Ostrava Syllabova 19 703 00 Ostrava Czech Republic

Faculty of Mining and Geology VŠB Technical University of Ostrava 708 33 Ostrava Czech Republic

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