title: Humeral shaft non-union after intramedullary nailing.
abstract: BACKGROUND
  The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture.
  
  
  METHODS
  From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle-proximal third and two in the middle third. In one case, a reverse shoulder prosthesis implant was associated to treat a co-existent rotator cuff massive lesion. The mean time between injury and treatment of non-union was 32 weeks (min 16-max 180); all patients were evaluated with Constant, DASH and UCLA score.
  
  
  RESULTS
  At the final follow-up (23.7 months), the mean Dash score was 22.25 pt, the Constant score was 64 pt, and the UCLA score value was 27 pt. The average pain value was 2 for the arm interested and 0 into PSA focus. Radiographic healing was obtained at 7 months.
  
  
  CONCLUSIONS
  The humeral shaft non-union is an invalidating problem which affects the daily living. Our treatment with plate, cortical bone graft, and PRP can build a high-stability structure that can help healing and graft integration.
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Campochiaro
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Baudi
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy. maurogialdini@gmail.com.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-2786-045X
authors.initials: M
authors.lastname: Gialdini
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Corradini
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Duca
authors.affiliation: Arciospedale Santa Maria Nuova Reggio Emilia, viale risorgimento 80, Reggio Emilia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rebuzzi
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catani
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011542:Pseudarthrosis / Q000601:surgery*
keywords: Humerus; Nailing; Non-union; Plate