Nonunion of the Humerus Following Intramedullary Nailing Treated by Ilizarov Hybrid Fixation

Raschke, Michael J.; Khodadadyan, C; Pd, Maitino; Hoffmann, Reinhard; Np, Südkamp

doi:10.1097/00005131-199802000-00013

Cited by 32 publications

(15 citation statements)

References 6 publications

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“…Nonunion occurs in approximately 10% of patients with humeral shaft fractures regardless of the type of treatment i.e. both conservative and surgical methods 23461011. The common causes of nonunion are infection, distraction at fracture site, unstable fixation, wrong choice of implant, iatrogenic devitalization of soft tissues, bone loss and osteoporosis 14.…”

Section: Discussionmentioning

confidence: 99%

“…Exchange nailing 415 for nonunion following intramedullary nailing has not been as successful as in other long bones like femur or tibia. Ilizarov’s ring fixator 56810111416 is useful, especially in such infected cases where plating and bone grafting would result in persistence of infection and non union 4. Adherence to the safe zones during pin insertion prevents any neurovascular complications.…”

Section: Discussionmentioning

confidence: 99%

“…The advantage of Ilizarov’s method is that it can be done even in the presence of infection and the deformity, if any, can also be corrected simultaneously. There is no necessity for bone grafting in most cases 51011. This prospective study discusses the outcome of nonunion of diaphyseal fractures of the humerus treated by Ilizarov’s method.…”

Section: Introductionmentioning

confidence: 99%

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Ilizarov′s method for treatment of nonunion of diaphyseal fractures of the humerus

Kiran¹,

Jee²

2010

Indian J Orthop

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Background:Nonunion in diaphyseal fractures of the humerus can be treated by various modalities like plating and bone grafting, exchange nailing, fibular strut grafting and Ilizarov’s method of ring fixation. To achieve union in infected nonunion in which multiple surgeries have already been done is further challenging. We conducted a prospective study wherein the outcome of the treatment of nonunion of diaphyseal fractures of the humerus by Ilizarov’s method was analyzed.Materials and Methods:Nineteen patients with diaphyseal nonunion of the humerus were treated by Ilizarov’s external fixator. These included nonunion after plating (n=11), intramedullary nailing (n=1) or conservative methods (n=7). In post-surgical infected nonunion (n=6), the implants were removed, debridement done, bone fragments were docked followed by application of ring fixator and compression. In aseptic nonunion (n=13), distraction for three weeks followed by compression was the protocol. Early shoulder and elbow physiotherapy was instituted. The apparatus was removed after clinical and radiological union and the results were assessed for bone healing and functional status.Results:Fracture union was achieved in all the 19 cases. Pin site infection was seen in 2 cases (10.52%). The bone healing results were excellent in eighteen cases (94.73%) and good in one case (5.26%).The functional results were found to be excellent in fourteen cases (73.68%), good in four (21.05%) and fair in one case (5.26%).Conclusion:Ilizarov’s method is an excellent option for treatment of septic and aseptic non union of diaphyseal fractures of the humerus as it addresses all the problems associated with non union of the humerus like infection, deformity and joint stiffness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ilizarov′s method for treatment of nonunion of diaphyseal fractures of the humerus

Kiran¹,

Jee²

2010

Indian J Orthop

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“…We applied 'callus massage' 16 at the sites of the fracture, alternating short periods of progressive distraction with periods of compression (0.5 mm of distraction a day for seven days, followed by 1 mm of compression a day for seven days, over a fourweek period). The result was net compression with slight shortening.…”

Section: Methodsmentioning

confidence: 99%

Nonunion of the humerus after failure of surgical treatment

Patel

Menon

Pool

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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W e used the Ilizarov circular external fixator to treat 16 patients with persistent nonunion of the diaphysis of the humerus despite surgical treatment. All patients had pain and severe functional impairment of the affected arm. In ten, nonunion followed intramedullary nailing. We successfully treated these by a closed technique. The nail was left in place and the fracture compressed over it. The fractures of the other six patients had previously been fixed by various methods. We explored these nonunions, removed the fixation devices and excised fibrous tissue and dead bone before stabilising with the Ilizarov fixator. In five patients union was achieved. Bone grafting was not required. In the single patient in whom treatment failed, there had been a severely comminuted open fracture. All except one patient had reduction of pain, and all reported an improvement in function.

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“…Older frames often required repeated adjustment to prevent misalignment of the docking site. The usage of the intramedullary nail in addition to the external fi xator served to help avoid misalignment of the docking site, leading to signifi cant decreases in external fi xation time together with better maintenance of anatomical length and alignment [ 43 ]. Alternatively, minimal invasive plate osteosynthesis (MIPO) may be used to confer similar advantages [ 44 ].…”

Section: Combination Techniquesmentioning

confidence: 99%