title: From plate to nail: a case-report of proximal humerus non-union.
abstract: The rate of non-union is estimated to be 1.1% to 10% following closed treatment of proximal humerus fracture. Treatment options include revision of fixation and biological enhancement using osteoprogenitor cells, growth factors and scaffolds. However, it is essential to plan the correct type of reconstructive strategy based on the evaluation of the non-union type. The use of the Non-Union Scoring System (NUSS) in this respect can aid the clinician to reach the right decision. We report a case of a 40 years old man who developed an aseptic proximal humerus non-union treated initially with ORIF (Philos(®) plate), bone substitute (Orthoss(®)) and bone morphogenetic protein 7 (BMP-7). Due to implant failure, twelve weeks later the fixation was revised to Titanium Cannulated Humeral Nail. Osseous healing was noted 5 months later.
authors.affiliation: Orthopedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pantalone
authors.affiliation: Orthopedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Vanni
authors.affiliation: Orthopedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Guelfi
authors.affiliation: Orthopedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Abate
authors.affiliation: Orthopedic and Trauma Department, Hospital Ravenna, Ravenna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Belluati
authors.affiliation: Orthopedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy. Electronic address: vsalini@unich.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Salini
mesh_terms: D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Non-Union Scoring System (NUSS); long bones; non-union; proximal humerus fracture