title: [Nonunion of the humeral diaphysis - operative and nonoperative treatment].
abstract: Operative treatment of acute humeral shaft fractures represents a major source of nonunions. The analysis of the biomechanical and biological causes of diaphyseal nonunions of the humerus is a prerequisite for the successful treatment of ununited humeral shaft fractures. Biologically active nonunions heal after debridement and correction of deformities with an improvement of mechanical stability, preferably by fixation with a compression plate. In atrophic nonunions, the restoration of the biologic capacity to restore osteogenesis by bone grafting is additionally necessary. The treatment of synovial pseudarthrosis and infected nonunion requires removal of bone and debridement of synovial and infected avascular tissues, respectively. Intramedullary nails to improve mechanical stability and nonoperative treatment with extracorporeal shock waves should only be used in a few special cases which do not have any severe deformities.
authors.affiliation: Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
authors.forename: U
authors.initials: U
authors.lastname: Bosch
authors.forename: M
authors.initials: M
authors.lastname: Skutek
authors.forename: W J
authors.initials: WJ
authors.lastname: Kasperczyk
authors.forename: H
authors.initials: H
authors.lastname: Tscherne
mesh_terms: D001696:Biomechanical Phenomena; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography
vernacular_title: Diaphysäre Oberarmpseudarthrosen - operative und konservative Behandlung.