Skip to main content

Advertisement

SpringerLink
Log in

Treatment of humeral shaft nonunions: nailing versus plating

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The aim of this study was to compare plating and nailing for treating nonunions of the upper two-thirds of the humerus.

Materials and methods

Fifty nonunions of the upper two-thirds of the humerus were treated by two different methods: 24 of them by unreamed locked nailing and bone graft (group A), and the other 26 by plate fixation and bone grafting (group B).

Results

All fractures healed in both groups. In group A, the time required for healing was 4.2 months (range 4–6 months), whereas in group B it was 4.7 months (range 4–6 months). This difference was statistically significant (p<0.05). Functional results and the range of motion of the shoulder and elbow were similar with both techniques. In group B there were 3 cases of transient, iatrogenic, radial nerve palsy.

Conclusions

We feel that both plate fixation and the unreamed humeral locked nail are good alternatives for the treatment of humeral shaft nonunions, although nailing achieves union earlier and has fewer complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a
Fig. 2a

Similar content being viewed by others

References

  1. Barquet A, Fernández A, Luvizio J, Masliah R (1989) A combined therapeutic protocol for aseptic nonunion of the humeral shaft: a report of 25 cases. J Trauma 29:95–98

    CAS  PubMed  Google Scholar 

  2. Crolla RMPH, Vries LS de, Clevers GJ (1993) Locked intramedullary nailing of humeral fractures. Injury 24:403–406

    CAS  PubMed  Google Scholar 

  3. Emmerson KP, Sher JL (1998) A method of treatment of non-union of humeral shaft fractures following treatment by locked intramedullary nail: a report of three cases. Injury 29:550–552

    CAS  PubMed  Google Scholar 

  4. Healy WL, White GM, Mick CA, Brooker AF, Weiland AJ (1987) Nounion of the humeral shaft. Clin Orthop 219:206–213

    PubMed  Google Scholar 

  5. Hornicek FJ, Zych GA, Hutson JJ, Malinin TI (2001) Salvage of humeral nonunions with onlay bone plate allograft augmentation. Clin Orthop 386:203–209

    PubMed  Google Scholar 

  6. Jupiter JB (1990) Complex non-union of the humeral diaphysis. J Bone Joint Surg Am 72:701–707

    CAS  PubMed  Google Scholar 

  7. Klestil T, Rangger CH, Kathrein A, Brenner E, Beck E (1997) Konservative und operative Therapie traumatischer Oberarmschaftbrüche. Chirurg 68:1132–1136

    Article  CAS  PubMed  Google Scholar 

  8. Kumar A, Sadiq SA (2002) Non-union of the humeral shaft treated by internal fixation. Int Orthop 26:214–216

    Article  CAS  PubMed  Google Scholar 

  9. Lammens J, Bauduin G, Driesen R, Moens P, Stuyck J, De Smet L et al (1998) Treatment of nonunion of the humerus using the Ilizarov external fixator. Clin Orthop 353:223–230

    Google Scholar 

  10. Marti RK, Verheyen CCPM, Besselaar PP (2002) Humeral shaft nonunion: evaluation of uniform surgical repair in fifty-one patients. J Orthop Trauma 16:108–115

    Article  CAS  PubMed  Google Scholar 

  11. Martínez AA, Herrera A, Cuenca J (2002) Good results with unreamed nail and bone grafting for humeral nonunion. Acta Orthop Scand 73:273–276

    Article  PubMed  Google Scholar 

  12. Martínez AA, Herrera A, Cuenca J (2002) Marchetti nailing with decortication and bone graft in non-unions of the two upper thirds of the humerus. Chir Main 21:28–32

    Article  PubMed  Google Scholar 

  13. Nast-Kolb D, Knoefel WT, Schweiberer L (1991) Die behandlung der oberarmschaftfraktur. Ergebnisse einer prospektiven AO-Sammelstudie. Unfallchirurg 94:447–454

    CAS  PubMed  Google Scholar 

  14. Patel VR, Menon DK, Pool RD, Simonis RB (2000) Nonunion of the humerus after failure of surgical treatment. Management using the ilizarov circular fixator. J Bone Joint Surg Br 82:977–983

    Article  CAS  PubMed  Google Scholar 

  15. Pietu G, Raynaud G, Letenneur J (1994) Treatment of delayed and nonunions of the humeral shaft using the Seidel locking nail: a preliminary report of five cases. J Orthop Trauma 8:240–244

    CAS  PubMed  Google Scholar 

  16. Ring D, Perey BH, Jupiter JB (1999) The functional outcome of operative treatment of ununited fractures of the humeral diaphysis in older patients. J Bone Joint Surg Am 81:177–190

    CAS  PubMed  Google Scholar 

  17. Rommens PM, Verbruggen J, Bross PL (1995) Retrograde locked nailing of humeral shaft fractures. J Bone Joint Surg Br 77:84–89

    CAS  PubMed  Google Scholar 

  18. Rubel IF, Kloen P, Campbell D, Schwartz M, Liew A, Myers E et al (2002) Open reduction and internal fixation of humeral nonunions. J Bone Joint Surg Am 84:1315–1322

    Google Scholar 

  19. Stewart MJ, Hundley JM (1955) Fractures of the humerus: a comparative study in methods treatment. J Bone Joint Surg Am 37:681–692

    Google Scholar 

  20. Svend-Hansen H, Skettrup M, Rathcke MW (1998) Complications using the Seidel intramedullary humeral nail: outcome in 31 patients. Acta Orthop Belg 63:291–295

    Google Scholar 

  21. Te Velde EA, Van der Werkin C (2001) Plate osteosynthesis for pseudarthrosis of the humeral shaft. Injury 32:621–624

    PubMed  Google Scholar 

  22. Thomsen NOB, Mikkelsen JB, Svendsen RN, Skovgaard N, Jensen CH, Jorgensen U (1998) Interlocking nailing of humeral shaft fractures. J Orthop Sci 3:199–203

    Article  CAS  PubMed  Google Scholar 

  23. Wu CC (1996) Humeral shaft non-union treated by a Seidel interlocking nail with a supplementary staple. Clin Orthop 326:203–208

    Article  PubMed  Google Scholar 

  24. Wu CC, Shih CH (1992) Treatment for non-union of the shaft of the humerus: comparison of plates and Seidel interlocking nails. Can J Surg 35:661–665

    CAS  PubMed  Google Scholar 

  25. Wu CC, Shih CH, Chen WJ, Tai CL (1998) Staple augmentation to treat a humeral non-union after failed Seidel locked nailing. Arch Orthop Trauma Surg 118:42–44

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Zaragoza, Spain

    Ángel A. Martínez, Jorge Cuenca & Antonio Herrera

  2. C/Princesa, 11–13, 1ºC, 50005, Zaragoza, Spain

    Ángel A. Martínez

Authors
  1. Ángel A. Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Cuenca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonio Herrera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ángel A. Martínez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martínez, Á.A., Cuenca, J. & Herrera, A. Treatment of humeral shaft nonunions: nailing versus plating. Arch Orthop Trauma Surg 124, 92–95 (2004). https://doi.org/10.1007/s00402-003-0608-7

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-003-0608-7

Keywords

Search

Navigation