title: Surgical management of diaphyseal humeral nonunion after intramedullary nailing: Wave-plate fixation and autologous bone grafting without nail removal.
abstract: Six patients with a nonunion of the humeral diaphysis after intramedullary nailing were treated with a wave plate and autologous bone graft but without removal of the intramedullary implant. The mean duration of the nonunion was 19 months (range, 6-36 months). At a mean follow-up of 12 months (range, 6-18 months), all six nonunions had healed, and patient satisfaction was high. Five patients had regained full shoulder function. One patient, who was treated for a rotator cuff tear before the humeral fracture, had a satisfactory functional outcome. Elbow motion was full in all but one patient. One patient had a postoperative radial nerve palsy, which recovered partially but did not require further surgery. This report suggests that healing of humeral nonunions can be achieved in the presence of intramedullary hardware.
authors.affiliation: Clinic for Trauma and Reconstructive Surgery, Humboldt University, Virchow Klinikum, Berlin, Germany. ariane.gerber@charite.de
authors.forename: Ariane
authors.initials: A
authors.lastname: Gerber
authors.forename: René
authors.initials: R
authors.lastname: Marti
authors.forename: Jesse
authors.initials: J
authors.lastname: Jupiter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D005260:Female; D005594:Fracture Fixation, Intramedullary; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D017211:Treatment Failure