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Introduction: The quality of reduction in proximal humerus fractures is valuable with radiographic criteria (Neck-shaft angle [NSA]; medial offset [MO]; distance head tuberosity [DHT] and subacromial space [SS]) that predict functionality. These criteria set for other implants are not described for the intramedullary nail., Material and Methods: Observational cohort study, retrospective, with patients 18 years, with osteosynthesis with intramedullary nail (2014 to 2017), evaluating demographic characteristics, severity of injury (Neer classification), progressive radiographic measurements and complications., Results: 84 cases with an average age of 65 ± 2 years and an average follow-up of 13.9 months were analyzed. By Neer rating 40.4% were grade II, 29.7% grade III and 29.7% grade IV. Consolidation in varus increases to 10.7% at the end of follow-up, with Neer III and IV patients. The 140° deformity is prevalent for Neer II (n = 15/34). 30.9% have a change of neck-shaft angle of 10°. Overall 86.9% has HTD changes 5 mm. Cases Neer III/IV 32% has alteration of SS 5 mm. The most common complication is avascular necrosis (AVN) with 44% of cases., Conclusions: Radiographic measurements have changes in long-term follow-up. Alterations in NSA ( 10o) and SS ( 5 mm) occur in higher proportion of Neer III/IV patients, according to the severity of the fracture, favoring vicious consolidations in varus or valgus and increased presence of AVN.

Alterations in the mechanical axis, complications of traumatic injuries and osteoarthritis are the leading causes for surgical reconstruction of the knee. According to the degree of the alteration, different surgical procedures are carried out, among which we find arthroscopy, mechanical axis aligning osteotomy, single compartment prosthesis, or total knee prosthesis. Indications for each one of these procedures depend on the type and degree of lesion. These treatments are not currently considered definitive or curative for osteoarthritis and their aim is mainly to improve the clinical conditions of the patient and to reduce as much as possible the evolution of the joint degenerative process. Even total knee arthroplasty, considered a definitive surgical procedure, is temporary due to its natural tendency to loosen and wear out., (Copyright © 2007 Elsevier España S.L Barcelona. Published by Elsevier Espana. All rights reserved.)