Management of Humeral Nonunion After the Failure of Locking Intramedullary Nails
- 1 October 1996
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Orthopaedic Trauma
- Vol. 10 (7), 492-499
- https://doi.org/10.1097/00005131-199610000-00008
Abstract
Summary We reviewed 21 cases of humeral nonunion following the failure of “locking” humeral nails. The nails had been inserted as the primary operative procedure following humeral fracture in fifteen cases or after the failure of closed treatment in six cases. Reconstruction after the failure of these implants was complicated by poor bone stock and difficulty in achieving union. Although technically difficult, open reduction and internal fixation with plating and bone grafting (successful in nine of nine cases) was more consistent than exchange nailing (successful in four of 10 cases) in achieving union (p = 0.01). Two patients refused further surgical intervention. The degree of bone loss associated with a loose nail, the lack of success of exchange nailing, and the insertion site morbidity associated with humeral nail removal differentiate these nonunions from similar lower extremity problems. The degree of bone loss following failed locking nailing of the humerus is a major concern, and exchange nailing alone may not be an acceptable option to deal with this problem.Keywords
This publication has 9 references indexed in Scilit:
- Compression Plating Versus Hackethal Nailing in Closed Humeral Shaft Fractures Failing Nonoperative ReductionJournal of Orthopaedic Trauma, 1995
- Treatment of Delayed and Nonunions of the Humeral Shaft Using the Seidel Locking NailJournal of Orthopaedic Trauma, 1994
- A Biomechanical Analysis of Four Humeral Fracture Fixation SystemsJournal of Orthopaedic Trauma, 1994
- Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical resultsThe Journal of Bone and Joint Surgery. British volume, 1994
- A Biomechanical Comparison of Intramedullary Nailing Systems for the HumerusJournal of Orthopaedic Trauma, 1993
- Locked nailing of humeral shaft fractures. Experience in Edinburgh over a two-year periodThe Journal of Bone and Joint Surgery. British volume, 1992
- A locking nail for fractures of the humerusThe Journal of Bone and Joint Surgery. British volume, 1991
- Hackethal Stacked Nailing of Humeral Shaft Fractures Experience with 30 PatientsPublished by Ovid Technologies (Wolters Kluwer Health) ,1983
- Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bonesThe Journal of Bone & Joint Surgery, 1976