Treatment of nonunions of humeral fractures with interlocking intramedullary nailing.
OBJECTIVE
To introduce the experience of treating nonunions of humeral fractures with interlocking intramedullary nailing.


METHODS
Twelve patients with humeral nonunions were treated with interlocking intramedullary nailing. The time interval between trauma and surgery was 10.5 months on average. Open reduction with anterograde approach was performed. Axial compression was specially applied to the fracture site with humeral nail holder after insertion of distal locked screws. Iliac bone grafting was added.


RESULTS
The average follow-up period was 21 months (ranging 9-51 months). All patients achieved osseous union 5.8 months after treatment on average. Eleven patients had good functions of the shoulder joints and the upper extremities. No patient experienced any permanent neurological deficit. Refracture of the original ununited region occurred in one patient after removal of the internal fixator one year later, but union was achieved after closed re-intramedullary nailing fixation.


CONCLUSIONS
Humeral interlocking intramedullary nailing is an effective alternative treatment for humeral nonunion.
Li
Xin-kui
XK
Institute of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. lixinkui@fmmu.edu.cn
Wang
Hai-qiang
HQ
Wei
Yi-yong
YY
Wu
Zi-xiang
ZX
D000328:Adult; D000368:Aged; D001858:Bone Nails; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome