Humeral shaft non-union after intramedullary nailing

Campochiaro, Gabriele; Baudi, Paolo; Gialdini, Mauro; Corradini, Alessandro; Duca, Vito; Rebuzzi, Manuela; Catani, Fabio

doi:10.1007/s12306-017-0468-x

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…Four out of thirteen studies, included 260 patients with long-bone nonunion, reported the pain relief effect of PRP injection ( Table 6 ). Campochiar et al ( 20 ) reported that the mean VAS scores decreased from 7 (5-9) preoperatively to 2 (0-3) at final follow-up, after receiving treatment of changing internal fixation, bone grafting, and PRP injection. Duramaz et al ( 22 ) mentioned that injection of PRP alone or changing intramedullary nail could both significantly lower preoperative VAS scores of patients suffering from femur and tibia nonunion.…”

Section: Resultsmentioning

confidence: 99%

“…However, there was no difference between two groups after 6 months. Campochiar et al ( 20 ) reported that after treatment with plate, cortical bone graft and PRP, the mean Dash, Constant, and UCLA scores were 22.25 (5.8-40.9), 64 (45-79), and 27 (22-34), respectively. Carlos et al ( 13 ) reported that there were no significant differences between the iliac crest autograft group and the iliac crest autograft combined with PRP group at the end of follow-up.…”

Section: Resultsmentioning

confidence: 99%

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Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis

Xing

Luo

et al. 2022

Front. Med.

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BackgroundMore recently, there was a series of clinical studies focusing on local administration of platelet-rich plasma (PRP) in long-bone fracture patients suffering from delayed union and nonunion. Therefore, we performed a systematic review to evaluate the effectiveness of PRP injection for treatment of patients with long-bone delayed union and nonunion.MethodsRelevant clinical trials were selected by the main bibliographic databases, including Medline, PubMed, Embase, Web of Science, and the Cochrane library, to evaluate the effectiveness of PRP for long-bone fracture patients diagnosed with delayed union or nonunion by two reviewers independently. The main outcomes included healing rate, healing duration, pain relief, functional outcome, and complications.ResultsFinally, thirteen studies including four hundred and fifty-nine participants met the selection criteria and were included in this systematic review. These articles included three randomized controlled studies, one prospective study, and nine retrospective studies. 146 out of 155 (94.19%) patients treated with PRP during operation, and 144 out of 183 (78.69%) patients treated with PRP injection alone, exhibited bone consolidation. The healing rate of the PRP group (85.80%) was higher than that of the control group (60.76%). The mean bony union time of patients treated and untreated with PRP, were, respectively, 4.64 and 5.15 months. Four papers reported that PRP was effective in pain relief of patient with delayed union and nonunion. Complications, including small subcutaneous hematoma, subcutaneous swelling, and postoperative infection, were also reported in enrolled studies.ConclusionsPRP is a promising alternative treatment for patients with long-bone delayed union and nonunion. PRP could successfully promote the healing rate and relieve the pain of patients with delayed union and nonunion. However, the long-term adverse side and functional outcome in application of PRP still need further large-scale trials and long-term follow-up.Systematic Review Registrationhttps://www.researchregistry.com/browse-the-registry#home/registrationdetails/61dbd2f837e948001e68d5c5/, The identifying number is research registry 7525.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis

Xing

Luo

et al. 2022

Front. Med.

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“…The non-union in humeral fractures using conservative management occurs in nearly 10% of the cases and treating such patients can be very difficult. 6,7 So to overcome this, different surgical modalities are in use with the main aim to allow early bone union and thus return to normal life activities. 8 Interlocking intramedullary nails (ILN) and dynamic compression plates (DCP) are the common surgical management options for these fractures.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Dynamic Compression Plate versus Interlock Intramedullary Nail for Management of Humeral Shaft Fractures

Nazar¹,

Khan²,

Khosa³

et al. 2021

PJMHS

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Objective: To compare outcomes of interlock intramedullary nails with Dynamic compression plates for the treatment of humerus shaft fractures in terms of hospital stay time and shoulder Impingement. Subjects and Methods: In this comparative study, a total number of 74 patients having age 20-60 years who presented with closed and open Gustilo type I or II in middle third of humerus were included. Study was conducted in Islam hospital Sialkot and and Rajib Tayyip Erdogan Hospital, Muzaffargarh from June-2019 to June-2020. Group A (n=37) patients underwent dynamic compression plating (DCP) for treatment of fractures and group B (n=37) underwent interlocking intramedullary nailing (ILN) for humerus shaft fractures. We noted post-operative hospital stay, shoulder impingement and bone union rate in all patients. Results: The mean of patients included in this study was 42.45 (SD 9.89) years. There were 57 (77.03%) males and 17 (22.97%) females. The mean duration of fracture at the time of surgery was 39.98±7.23 days. Mean hospital stay was 4.72±1.23 days in in group A and 4.89±1.40 days in group B (p-value 0.60). There were 4 (10.8%) patients in group B in whom shoulder impingement occurred but there was no patient in group A with shoulder impingement (p-value 0.04). Complete union occurred in 35 (94.6%) patients in DCP group and in 34 (91.8%) patients in ILN group (p-value 0.64). Conclusion: Both DCP and ILN are associated with high bone union rates. The complications rate of ILN is higher in comparison to DCP group. Keywords: Humerus shaft fractures, dynamic compression plates, interlocking intramedullary nailing.

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“…Apart from high energy trauma such as falls from great height and traffic accidents also low energy trauma such as falls from stumbling by elderly people is a common accident mechanism [ 3 ]. The therapy of the humeral shaft fracture is manifold and controversial as a result of its anatomic relationship to the radial nerve and because of the high likeliness to develop a non-union [ 4 , 5 ]. Previously it belonged to the domain of conservative treatment with immobilization in a brace according to Sarmiento et al [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

New ways of treatment of fractures of the humeral shaft: does the combination of intramedullary nail osteosynthesis and cerclage improve the healing process?

Helm

Fenwick

Reuter

et al. 2021

Eur J Trauma Emerg Surg

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Introduction The humeral shaft fracture is a rare fracture of the long bones with various treatment options. Dreaded complications such as lesions of the radial nerve or non-unions make the decision for what kind of therapy option more difficult. Biomechanically the upper arm is mostly exposed to rotational forces, which affect intramedullary nail osteosynthesis. Additive cerclage may compensate for these in spiral fractures. The aim of this study is to investigate what effect a combination of intramedullary nail osteosynthesis and limited invasive cerclage has on the rate of healing. In addition, this study addresses the question if complications arise as a result of cerclage. Methods In this retrospective study, 109 patients were evaluated, who, during a period of 6 years, underwent operative treatment of a humerus shaft fracture with a combination of intramedullary nail osteosynthesis and additive cerclage. The primary end point was to establish the rate of healing. A secondary end point was to evaluate complications such as infections and damage to the nerve. This was followed by an examination of patient files and X-ray images and a statistical analysis with SPSS. Results and conclusion The healing process shows a non-union rate of 2.6%, and complications such as secondary radial nerve lesions of 4.6%. The antegrade intramedullary nail osteosynthesis with limited invasive, additive cerclage reduces the risk of non-union and does not lead to an increased risk of iatrogenic damage to the radial nerve. Wound healing was not impaired and there were no infections through the cerclage in our patient cohort.

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Humeral shaft non-union after intramedullary nailing

Abstract: 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.

Cited by 8 publications

References 19 publications

Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis

Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis

Outcome of Dynamic Compression Plate versus Interlock Intramedullary Nail for Management of Humeral Shaft Fractures

New ways of treatment of fractures of the humeral shaft: does the combination of intramedullary nail osteosynthesis and cerclage improve the healing process?

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