Tips of the trade #34. Removal of broken rush pins.
Reported rates of nonunion with the nonoperative treatment of isolated humeral shaft fractures (nonpathologic bone) are low. Higher rates (13%) in open fractures are reported; open intramedullary nails may contribute to this nonunion rate. In this situation, when we identify a fractured pin, an anterolateral approach is used. The proximal pin is removed and the nonunion site is identified. The fibrous nonunion or pseudoarthrosis is excised and the distal pin fragment is identified in the intramedullary canal. A drill bit is used to remove the rod. Bone grafting is also generally utilized.
Pitcher
J D
JD
Orthopaedic Surgery Service, Tripler Army Medical Center, Honolulu, Hawaii.
Atkinson
R E
RE
D001858:Bone Nails; D005594:Fracture Fixation, Intramedullary; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D011542:Pseudarthrosis / Q000601:surgery*; D012086:Reoperation