Open exchange locked nailing in humeral nonunions after intramedullary nailing

Clinical Orthopaedics and Related Research
Jinn LinSheng-Mou Hou

Abstract

Humeral nonunions after cannulated intramedullary nailing have been difficult to reconstruct. In the current study, 23 consecutive patients were treated by open exchange locked nailing with bone grafting. There were 16 men and seven women with a mean age of 46.2 years. The nonunions followed humeral locked nailing in eight patients, Seidel nailing in 13, and Küntscher nailing in two. The average nonunion time was 14.7 months. The nonunions, located at the proximal (1/3) in four humeri, middle (1/3) in 15, and distal (1/3) in four, were antegrade nailed in 10 and retrograde nailed in 13. Nineteen had 8-mm nails and four had 7-mm nails. Supplementary wiring was used in 19 patients. The average followup was 21.4 months. With one surgery, all but one patient (96%) achieved osseous union in, on average, 16.3 weeks. One patient with chronic renal dialysis had persistent nonunion and an osteolytic supracondylar fracture. Other complications included one postoperative radial nerve palsy, one brachial artery injury, and one wire infection. At followup, all patients with solid union had excellent or satisfactory recovery of shoulder function. The average postoperative Neer score (90.7) was significantly better than the average preoperati...Continue Reading

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Citations

Feb 8, 2016·Archives of Orthopaedic and Trauma Surgery·Jan GessmannDominik Seybold
Jun 17, 2006·Injury·George M KontakisPeter V Giannoudis
Jan 4, 2007·The Journal of Bone and Joint Surgery. American Volume·Mark R Brinker, Daniel P O'Connor
Dec 24, 2017·International Orthopaedics·Markus RuppVolker Alt
Oct 31, 2020·Archives of Orthopaedic and Trauma Surgery·Andrew LeeAnil Dutta
May 25, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Julien GaillardAdeline Cambon-Binder

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