Abstract
Introduction
Plating with bone grafting is considered the gold standard treatment for nonunion
of humeral shaft fractures. However, this complex procedure involves multiple risks.
The aim of this study is to evaluate an alternative treatment using isolated axial
interfragmentary compression for the dynamisation of humeral shaft nonunion after
retrograde locked nailing.
Materials and methods
Between January 2000 and May 2009, 124 humeral shaft fractures were treated in our
trauma department with retrograde locked nailing using the unreamed humeral nail (UHN®, Synthes, Paoli, PA, USA). Nonunion occurred in seven patients (5.6%) – five females
and two males, mean age 44 years (range: 17–73 years). The nonunion was treated by
applying isolated secondary interfragmentary compression. Mean follow-up was 43 months
(range: 8–74 months). The Rommens score and the disabilities of the arm, shoulder
and hand (DASH) score were used to evaluate the global functioning of the upper limb.
Results
The compression procedure was successful in all seven cases. In each case, the union
occurred without any complications in 3–5 months. The mean DASH score was 25/100 (range:
8.3–60.8/100). The Rommens score was judged excellent for five of the seven patients
but two were rated moderate. One of these suffered from complex regional pain syndrome
type II since the fracture, and another developed a stiff shoulder 6 months after
trauma.
Conclusion
Isolated secondary interfragmentary compression appears to be a simple and successful
procedure in cases of humeral nonunion.
Keywords
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Article info
Publication history
Accepted:
May 24,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
