A Combined Therapeutic Protocol for Aseptic Nonunion of the Humeral Shaft

Barquet, Antonio; Fernández, Alberto Hernández; Luvizio, J; Masliah, Roberto

doi:10.1097/00005373-198901000-00020

Cited by 53 publications

(37 citation statements)

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“…Aseptic non-union of the humeral shaft is commonly treated either by compression plating or intramedullary nailing. A high success rate has been reported after using a compression plate [1,3,5,6,12]. In our series, a union rate of 91% compares with the findings of Healy et al [5] who reported union in 92% of cases, and Barquet et al [1] who reported a union rate of 96% with the use of a compression plate and cancellous bone grafting.…”

Section: Discussionsupporting

confidence: 84%

“…These include compression plating and bone grafting [1,3,4,5,6,12,13], intramedullary nailing [2], vascularised fibular grafting [7] and Ilizarov external fixator [9]. We are presenting our results of open reduction and internal fixation using a dynamic compression plate (DCP) with cancellous bone grafting in non-union of the humeral shaft.…”

Section: Introductionmentioning

confidence: 99%

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Non-union of the humeral shaft treated by internal fixation

Kumar

Sadiq

2002

International Orthopaedics (SICOT)

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We reviewed 40 cases with non-union of the humeral shaft. There were 31 men and nine women patients with an average age of 38.5 (35-65) years. Thirtyfour non-unions were of the atrophic type. Non-union was most often found at the transition of the middle third to the lower third of the humeral shaft. Six fractures were classified as open at the time of the initial injury. All patients were treated by open reduction and internal fixation with a dynamic compression plate (DCP). Cancellous bone graft was used in all atrophic non-unions. In one patient an additional fibular graft was used. The average follow-up was 13 (6-18) months. Final results were available for 34 patients. Thirty-one fractures (91%) healed in an average of 4.5 (3-9) months. Main complications were temporary radial nerve palsy in two patients and deep infection in one.Résumé Nous avons examiné 40 cas de non -consolidation de la diaphyse humérale. Il y avait 31 hommes et neuf femmes avec un âge moyen de 38.5 années (35-65 années). Trente-quatre non -consolidations étaient du type atrophique. Le défaut de consolidation était le plus souvent à la jonction 1/3 moyen-1/3 inférieur de la diaphyse humérale. Six fractures ont été classées comme ouvertes au temps de la blessure initiale. Tous les malades ont été traités par réduction ouverte et fixation interne avec une plaque à compression dynamique. Une greffe spongieuse a été utilisé dans tous les cas de non-consolidation atrophique. Chez un malades une greffe supplé-mentaire de péroné a été utilisée. La moyenne de suivi était 13 mois (6-18 mois). Les résultats définitifs étaient disponibles pour 34 malades. Trente-une fractures (91%) ont guéri dans une période moyenne de 4,5 mois (3-9 mois). Les principales complications étaient une paralysie temporaire du nerf radial pour deux malades et une infection profonde pour un patient.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Non-union of the humeral shaft treated by internal fixation

Kumar

Sadiq

2002

International Orthopaedics (SICOT)

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“…For uniformity, all patients received bone grafting, consistent with other studies. 9,17,20 Bone grafts can be taken from the hypertrophic non-union site. They may be unnecessary in hypertrophic non-unions, particularly when the fracture was of a short, oblique-type, owing to the lack of space between fracture gap.…”

Section: Discussionmentioning

confidence: 99%

“…Ilizarov external fixation has yielded a union rate of 94%, 7,8 but requires long fixation time and risks pin-tract infection and patient discomfort because of the large size of the frame. Plate fixation with bone grafting achieves a union rate of >90%, [9][10][11][12][13][14][15][16][17][18][19][20] but requires a wide dissection which entails a high risk of damage to the radial nerve (around 5%). 11,[13][14][15][16]18 Poor bone quality or a deficient plate technique may lead to non-union.…”

Section: Introductionmentioning

confidence: 99%

Two-Plate Fixation for Humeral Shaft Nonunions

Martı́nez¹,

Cuenca²,

Herrera

2009

J Orthop Surg (Hong Kong)

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Purpose.To review 22 patients who underwent 2-plate fixation for non-union of the humeral shaft. Methods. 13 women and 9 men aged 32 to 76 (mean, 48) years underwent fixation for non-union of the humeral shaft, using a 2-plate construct, together with decortication, debridement, and bone grafting. The two 3.5-mm reconstruction plates were parallel and lying at 90º to each other and fixed with screws purchasing into at least 6 cortices of each fragment for both plates. Fractures were located in the upper third (n=8) or middle third (n=14) of the humerus. Initial treatments included casting (n=9), coaptation splinting (n=8), multiple retrograde pinning (n=4), and Marchetti-Vicenzi nailing (n=1). 18 non-unions were atrophic and 4 were hypertrophic. Shoulder and elbow range of motion as well as functional results were evaluated. iatrogenic radial nerve palsy that recovered within 3 months. Conclusion. Two-plate fixation achieves good results for humeral shaft non-unions.

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“…[34,35] Low-intensity pulsed US waves have therapeutic effects on different disorders such as bone fracture healing, osteoporosis, and pain relieving. [36][37][38][39][40][41] Clinical evidence shows the efficiency of very low-intensity US on bone and soft tissue healing. At low intensities, thermal effects are not likely the responsible mechanism of action.…”

Section: Biological Interactions Of Usmentioning

confidence: 99%

Untitled

Rashidi

2017

IJGP

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Objective: Ultrasound (US) waves have unique characteristics that making them promising option for treatment of different soft tissue injuries particularly wounds. The mechanisms of actions of this technique in the treatment of soft tissue are not fully understood. This paper aimed to comprehensively review the biological interactions and mechanism of action of US waves in the treatment of chronic wounds. Methods: The databases of PubMed (1990PubMed ( -2016, EMBASE (1990EMBASE ( -2016, Web of Sciences (1990), and Google Scholar (1980 were searched using the set terms "US waves" and "wound treatment," "mechanism of action" and "soft tissue injuries," and "biologi8cal interaction." The title and abstract of the collected results were reviewed by two authors, and the relevant papers were selected for further evaluations. Results: The mechanisms of action depend on the US physical parameters as well as exposure factors including duration and injury type. The main mechanisms of US waves for wound healing are enhancing the rate of inflammatory phase, stimulating fibroblasts to secrete collagen, enhancing extensibility of collagen, circulation, pain threshold, enzymatic activity, permeability of cell membrane, and accelerating nerve conduction. Conclusion: The therapeutic effects of US depend on dose (W/cm 2 ) and dosage (frequency of application). Low US frequencies show more therapeutic efficiency in wound healing compared with high frequencies.

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A Combined Therapeutic Protocol for Aseptic Nonunion of the Humeral Shaft

Cited by 53 publications

References 0 publications

Non-union of the humeral shaft treated by internal fixation

Non-union of the humeral shaft treated by internal fixation

Two-Plate Fixation for Humeral Shaft Nonunions

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