Nonunions of the Humerus

Volgas, David A.; Stannard, James P.; Alonso, Jorge E.

doi:10.1097/00003086-200402000-00008

Cited by 167 publications

(108 citation statements)

References 31 publications

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“…Operative fixation of diaphyseal humeral fractures is associated with a nonunion rate ranging from 15 to 30% compared to a nonunion rate of 0 to 13% for nonoperatively treated diaphyseal humeral fractures [8]. Lacking from current literature is the prognosis of patients who develop humeral diaphyseal nonunions in the setting of initial operative versus nonoperative treatment.…”

Section: Discussionmentioning

confidence: 99%

Initial Surgical Treatment of Humeral Shaft Fracture Predicts Difficulty Healing when Humeral Shaft Nonunion Occurs

2015

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Section: Discussionmentioning

confidence: 99%

Initial Surgical Treatment of Humeral Shaft Fracture Predicts Difficulty Healing when Humeral Shaft Nonunion Occurs

2015

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“…N onoperative treatment of diaphyseal humeral fractures is associated with a reported union rate of 92% to 98%, and angular deformity and shortening are well tolerated [1][2][3][4][5] . In contrast, nonunion is disabling because of pain and instability [6][7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Fracture Mobility Six Weeks After Initiation of Brace Treatment of Mid-Diaphyseal Humeral Fractures

Neuhaus

Menendez

Kurylo³

et al. 2014

Journal of Bone and Joint Surgery

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BACKGROUND: Recent studies have identified specific subsets of diaphyseal humeral fractures for which functional bracing is less effective. The present study tested the hypothesis that a gap between fracture fragments may be a risk factor (after accounting for other potential risk factors) for fracture instability six weeks after functional bracing of humeral shaft fractures. METHODS: We retrospectively identified seventy-nine adult patients (forty-six men, thirty-three women; forty-two fractures on the right side, thirty-seven fractures on the left), each with an acute, closed, AO type-A2 (oblique, 30°) or type-A3 (transverse, lt;30°) mid-diaphyseal humeral shaft fracture treated nonoperatively at three different level-I trauma centers from June 2004 to August 2011. The gap between the fracture fragments was measured on the first radiographs made after the affected upper extremity was placed in a brace. RESULTS: Sixty-three patients (80%) had documented healing of the fracture. Sixteen patients (20%) had motion at the fracture site and a persistent fracture line shown on radiographs six weeks or more after injury. In multivariable analysis, each millimeter of gap between the main fragments with the patient wearing the brace (odds ratio [OR] = 1.4, 95% confidence interval [CI] = 1.1 to 1.7), smoking (OR = 5.8, 95% CI = 1.4 to 25), and female sex (OR = 5.3, 95% CI = 1.2 to 23) increased the risk of fracture instability six weeks after injury (R2 = 0.38, area under the receiver operating characteristic [ROC] curve = 0.81). CONCLUSIONS: The magnitude of the gap between the fracture fragments is an independent risk factor for fracture instability and the lack of a bridging callus six weeks after a diaphyseal humeral fracture. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…Volgas ve ark. ise yaptığı derlemede, humerus kırıklarının görülme sıklığının tüm kırıklar arasında %5 ile %8 arasında olduğunu ve kaynama problemlerinin yaygın olmadığını bildirmişlerdir (34). Kaynamama ya da yanlış kaynama için genel risk faktörlerinin; cinsiyet, yaş, diyabet, obezite, sigara ve alkol kullanımı, osteoporoz ve non-steroid antiinflamatuar ilaçlar olduğu bildirilmiştir.…”

Section: Gereç Ve Yöntemunclassified

“…Kaynamama ya da yanlış kaynama için genel risk faktörlerinin; cinsiyet, yaş, diyabet, obezite, sigara ve alkol kullanımı, osteoporoz ve non-steroid antiinflamatuar ilaçlar olduğu bildirilmiştir. Vasküler hasarlar ise, lokal risk faktörleri arasında yer almaktadır (35,34). Ön kolun a. radialis ve a. ulnaris tarafından oluşturulan kollateraller ile dolaşımı sağlanmaktadır.…”

Section: Gereç Ve Yöntemunclassified

Humerus, Radius Ve Ulna’daki̇ Foramen Nutricium’larin Anatomi̇si̇ (Bi̇r Derleme)

Korkmaz¹,

Gürses²,

Gayretli³

et al. 2016

İst Tıp Fak D

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The nutrient foramina are reported as a cause for union defects in humerus, radius and ulna fractures. We aimed to review the relationship between the anatomy of the nutrient foramina and fractures of these bones. Materials and Methods:We performed an internet search via Pubmed and Google Scholar. We obtained full-text articles of 27 papers. We included 23 articles in our study. Eight studies investigated only humerus, 1 investigated radius, 1 investigated ulna, 1 investigated radius and ulna, and 12 investigated all three bones. We used additional 21 articles for a clinical viewpoint. Therefore 44 references were included in our study. Results: For humerus, foraminal index (the ratio of the distance between nutrient foramen and proximal end of the bone to total bone length) ranged between 32.7 and 59.1, and mostly the foramina located at the anteromedial surface. For radius, foraminal index ranged between 32.7 and 44.52, and mostly the foramina located at the anterior surface. For ulna, foraminal index ranged between 35.7 and 41.97, and mostly the foramina located at the anterior surface. Conclusion:The number and location of the foramina are concordant among different ethical groups. The most common site of union defects for humerus is the proximal 1/3. This complication is attributed to the attachments of strong skeletal muscles to this region. In forearm, non-unions tend to occur at the distal 1/3. At this region, blood supply is diminished due to the decrease of number of branches from the nutrient artery.

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Nonunions of the Humerus

Cited by 167 publications

References 31 publications

Initial Surgical Treatment of Humeral Shaft Fracture Predicts Difficulty Healing when Humeral Shaft Nonunion Occurs

Initial Surgical Treatment of Humeral Shaft Fracture Predicts Difficulty Healing when Humeral Shaft Nonunion Occurs

Risk Factors for Fracture Mobility Six Weeks After Initiation of Brace Treatment of Mid-Diaphyseal Humeral Fractures

Humerus, Radius Ve Ulna’daki̇ Foramen Nutricium’larin Anatomi̇si̇ (Bi̇r Derleme)

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