Management of humeral nonunion after the failure of locking intramedullary nails.

Abstract:

: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.

journal_name

J Orthop Trauma

authors

McKee MD,Miranda MA,Riemer BL,Blasier RB,Redmond BJ,Sims SH,Waddell JP,Jupiter JB

doi

10.1097/00005131-199610000-00008

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

492-9

issue

7

eissn

0890-5339

issn

1531-2291

journal_volume

10

pub_type

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