Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion
Introduction. Although the recommended treatment for humeral shaft nonunion is compression plating with autologous bone grafting, we treated a case of humeral shaft nonunion with an intramedullary nail (IMN) without bone grafting. Presentation of Case. Osteosynthesis with IMN was performed on a 24-y...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2021/5548729 |
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| author | Genta Fukumoto Tomoaki Fukui Keisuke Oe Atsuyuki Inui Yutaka Mifune Ryosuke Kuroda Takahiro Niikura |
| author_facet | Genta Fukumoto Tomoaki Fukui Keisuke Oe Atsuyuki Inui Yutaka Mifune Ryosuke Kuroda Takahiro Niikura |
| author_sort | Genta Fukumoto |
| collection | DOAJ |
| description | Introduction. Although the recommended treatment for humeral shaft nonunion is compression plating with autologous bone grafting, we treated a case of humeral shaft nonunion with an intramedullary nail (IMN) without bone grafting. Presentation of Case. Osteosynthesis with IMN was performed on a 24-year-old man with a humeral shaft fracture at another hospital. However, bony union was not obtained 1 year after the first surgery, and he was referred to our institution. We treated the nonunion with exchange nailing without autologous bone grafting using compression function of the nail, leading to bony union at 7 months postoperatively. At the final follow-up 2 years and 4 months postoperatively, the patient had full range of motion in the left shoulder and elbow joints. Discussion. Compression plating with autologous bone grafting is reported to be the gold standard for the treatment of humeral shaft nonunion. IMN is advantageous for minimal invasion; however, the conventional type of IMN cannot apply compression force between fragments and does not have sufficient stability against rotational force. In this case, we used an IMN that could apply compression between the fragments and which had rotational stability via many screws. We did not perform bone grafting because the current nonunion was adjudged to be biologically active, and we achieved good functional results. Conclusion. We treated humeral shaft nonunion using IMN with compression, but without bone grafting, leading to successful clinical outcomes. This strategy might be an appropriate choice for the treatment of humeral shaft nonunion with biological activity. |
| format | Article |
| id | doaj-art-77fe9371f4924450b61845cc43b4a078 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-77fe9371f4924450b61845cc43b4a0782025-02-03T00:58:49ZengWileyCase Reports in Orthopedics2090-67492090-67572021-01-01202110.1155/2021/55487295548729Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft NonunionGenta Fukumoto0Tomoaki Fukui1Keisuke Oe2Atsuyuki Inui3Yutaka Mifune4Ryosuke Kuroda5Takahiro Niikura6Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanIntroduction. Although the recommended treatment for humeral shaft nonunion is compression plating with autologous bone grafting, we treated a case of humeral shaft nonunion with an intramedullary nail (IMN) without bone grafting. Presentation of Case. Osteosynthesis with IMN was performed on a 24-year-old man with a humeral shaft fracture at another hospital. However, bony union was not obtained 1 year after the first surgery, and he was referred to our institution. We treated the nonunion with exchange nailing without autologous bone grafting using compression function of the nail, leading to bony union at 7 months postoperatively. At the final follow-up 2 years and 4 months postoperatively, the patient had full range of motion in the left shoulder and elbow joints. Discussion. Compression plating with autologous bone grafting is reported to be the gold standard for the treatment of humeral shaft nonunion. IMN is advantageous for minimal invasion; however, the conventional type of IMN cannot apply compression force between fragments and does not have sufficient stability against rotational force. In this case, we used an IMN that could apply compression between the fragments and which had rotational stability via many screws. We did not perform bone grafting because the current nonunion was adjudged to be biologically active, and we achieved good functional results. Conclusion. We treated humeral shaft nonunion using IMN with compression, but without bone grafting, leading to successful clinical outcomes. This strategy might be an appropriate choice for the treatment of humeral shaft nonunion with biological activity.http://dx.doi.org/10.1155/2021/5548729 |
| spellingShingle | Genta Fukumoto Tomoaki Fukui Keisuke Oe Atsuyuki Inui Yutaka Mifune Ryosuke Kuroda Takahiro Niikura Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion Case Reports in Orthopedics |
| title | Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion |
| title_full | Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion |
| title_fullStr | Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion |
| title_full_unstemmed | Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion |
| title_short | Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion |
| title_sort | closed compression nailing using a new generation intramedullary nail without autologous bone grafting for humeral shaft nonunion |
| url | http://dx.doi.org/10.1155/2021/5548729 |
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