Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Orthopaedic Surgery & Traumatology
Published in: European Journal of Orthopaedic Surgery & Traumatology 4/2015

01-05-2015 | Original Article

Results of non-union of humerus treated with retrograde humeral nail

Authors: Hinesh Bhatt, Bobin Varghese, Hannah Phillips, Rohit Rambani, Subhash Halder

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2015

Login to get access

Abstract

Treating non-union of humerus fracture is a surgical challenge with variable outcome. We report series of 51 adult patients of aseptic non-union of humerus from 1998 to 2010 treated retrograde humeral nail. The mean age of patient was 54 years with 33 females and 18 males. The mean duration of non-union was 8 months. In 48 out of 51 cases (94 %), union was achieved at mean duration of 10.1 months. Thirty-two out of 51 patients needed bone grafting. Three patients had post-operative radial nerve neuropraxia which fully recovered. At last visit, mean Constant score for shoulder was 83 and mean Mayo score for elbow 78. Our series with this implant shows excellent union rates for extra articular humeral non-unions in adults.
Literature
1.
2.
Green DP, Bucholz RW, Heckman JD, Zuckerman JD, Koval KJ (1996) Fractures of the shaft of the humerus. In: Rockwood CA (ed) Fractures in adults, 4th edn. Lippincott-Raven, Philadelphia, pp 1025–1054
3.
Sanchez-Sotelo (2009) Distal humeral non-union. J Instr Course Lect 58:541–548
4.
Chhabra AB, Golish SR, Pannunzio ME, Butler TE Jr, Bolano LE, Pederson WC (2009) Treatment of chronic non-union of the humerus with free vascularized fibula transfer: a report of thirteen cases. J Reconstr Microsurg 25(2):117–124CrossRefPubMed
5.
Bernard de Dompsure R, Peter R, Hoffmeyer P, (2010) Uninfected non-union of the humeral diaphyses: review of 21 patients treated with shingling, compression plate, and autologous bone graft. Orthop Traumatol Surg Res 96(2):139–146CrossRefPubMed
6.
Garnavos C, Mouzopoulos G, Morakis E (2010) Fixed intramedullary nailing and percutaneous autologous concentrated bone-marrow grafting can promote bone healing in humeral-shaft fractures with delayed union. Injury 41(6):563–567CrossRefPubMed
7.
Yamane S, Suenaga N, Oizumi N, Minami A (2008) Interlocking intramedullary nailing for non-union of the proximal humerus with the straight nail system. J Shoulder Elbow Surg 17(5):755–759CrossRefPubMed
8.
Lin J, Hou SM (2003) Locked-nail treatment of humeral surgical neck non-union. J Trauma Mar 54(3):530–535CrossRef
9.
Patel VR, Menon DK, Pool RD, Simonis RB (2000) Non union of humerus after failure of surgical treatment management using ilizarov circular fixator. J Bone Joint Surg Br 82-B:977–983CrossRef
10.
Lin J (1998) Treatment of humeral shaft fractures with humeral locked nail and comparison with plate fixation. J Trauma 44(5):859–864CrossRefPubMed
11.
Crawford CH 3rd, Seligson D (2009) Atrophic non-union of humeral diaphysis treated with locking plate and recombinant bone morphogenetic protein: nine cases. Am J Orthop (Belle Mead NJ) 38(11):567–570
12.
Halder SC, Chapman JA, Choudhury G, Wallace WA (2001) Retrograde fixation of fractures of the neck and shaft of humerus with ‘Halder humeral nail’. Injury 32(9):695–703CrossRefPubMed
13.
Pugh DM, McKee MD (2003). Advances in the management of humeral non-union. J Am Acad Orthop Surg 11(1):48–59
14.
Farrragos AF, Schemish FH (1999) Complications of intramedullary nailing for humeral shaft: a review. J Orthop Trauma 13(4):258–267
15.
Ali A, Douglas H, Stanley D (2005) Revision surgery for non-union after early failure of fixation of fractures of the distal humerus. J Bone Joint Surg Br 87(8):1107–1110
16.
Prasarn ML, Achor T, Paul O, Lorich DG, Helfet DL (2010) Management of non-union of the proximal humeral diaphysis. Injury 41(12):1244–1248CrossRefPubMed
17.
Wallace A (2003) Problems with Halder nail fixation of humerus fractures. Injury 34(3):245 author reply 246CrossRefPubMed
18.
Hornicek FJ, Zych GA, Hutson JJ, Malinin TI (2001) Salvage of humeral non-union with on lay bone plate allograft augmentation. Clin Orthop Relat Res 386:203–209CrossRefPubMed
19.
Rubel IF, Kloen P, Campbell D, Schwartz M, Liew A, Myers E et al (2002) Open reduction and internal fixation of humeral non-union: a biomechanical and clinical study. J Bone Joint Surg Am 84(8):1315–1322PubMed
20.
Allende C, Allende BT (2009) The use of a new locking 90 degree blade plate in the treatment of atrophic proximal humerus non-unions. Int Orthop 33(6):1649–1654
21.
Martinez AA, Cuenca J, Herrera A (2009) Two-plate fixation for humeral shaft non-unions. J Orthop Surg (Hong Kong) 17(2):135–138
22.
Hamilton SW, Baird KS (2009) The treatment of established non union of the proximal humerus using the Polarus locking intramedullary nail. Int J Shoulder Surg 3(3):53–56CrossRefPubMedCentralPubMed
23.
Ring D, Kloen P, Kadzeilski J, Helfet D, Jupiter JB (2004) Locking compression plates for osteoporotic non unions of diaphyseal humerus. Clin Orthop Relat Res 425:50–54CrossRefPubMed
24.
Badman BL, Mighell M, Kalandiak SP, Prasarn M (2009) Proximal humeral non-union treated with fixed-angle locked plating and an intramedullary strut allograft. M. J Am Acad Orthop Surg 16(5):294–302
Metadata
Title
Results of non-union of humerus treated with retrograde humeral nail
Authors
Hinesh Bhatt
Bobin Varghese
Hannah Phillips
Rohit Rambani
Subhash Halder
Publication date
01-05-2015
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-014-1563-4

Other articles of this Issue 4/2015

European Journal of Orthopaedic Surgery & Traumatology 4/2015 Go to the issue

Original Article

Shoulder arthroscopy remains superior to direct MR arthrography for diagnosis of subtle rotator interval lesions

Original Article

Review of 41 Neer’s mini-open operations with up to nine-year follow-up and a study of the influence of occupational disease

Editorial

Revision total knee arthroplasty: the end of the allograft era?

Original Article

Cemented metal-on-metal total hip replacement with 28-mm head: prospective, long-term, clinical, radiological and metal ions data

Original Article

Assessing the validity of the modified Blumensaat method for radiographic evaluation of patellar height

Original Article

The intra- and inter-observer reliability of the CT-scan based X index to quantify glenoid bone loss in chronic anterior shoulder instability and its impact on decision making