Locked intramedullary nailing results in treatment of humerus diaphyseal pseudoarthrosis

Abstract

The technique of intramedullary nailing in the treatment of pseudarthrosis of the humeral diaphysis clinical, radiological and functional results were evaluated. The study of pseudarthrosis of the humeral diaphysis were treated with the diagnosis of intramedullary nailing technique in 28 patients (11 males, 17 females; mean age 50.3, range 26-73 years) were included. Six of these cases were hypertrophic type and 22 of them were atrophic type pseudarthrosis. Twelve of the cases were on the right and 16 were on the left. From 28 cases with pseudarthrosis, 18 had a mean of 1.5 (1-3) failed surgeries and 10 receieved conservative methods before treatment. For all locked intramedullary nailing cases antegrad, front and carved techniques were applied. All patients underwent bone grafting. Functional evaluation was made according to the Hunter's and Constan-Murley's shoulder scoring system. The mean follow-up was 36.2 months (range 7 to 43 months). Twentysix of these 28 cases were succesfully treated and united. Pseudarthrosis was seen in two cases. The average duration of healing 16.5 (11-25) weeks, respectively. None of the cases had surgery-related vascular problems. Radial nerve palsy was observed in one of the cases after surgery and because nerve lesion did not improve Self-tendon transfer was performed on the patient. None of the patients had no anterior-posterior and lateral angulation. There was no significant rotational deformity radiologically. None of the patients developed surgery-related infection. In postoperative radiological evaluation, the proximal tip of the nail was found high in three patients. Functional evaluation accordingto the criteria Hunter 21 cases were excellent, 7 cases were good; Constant-Murley score 22 cases were very good, 6 cases were good. In according to treatment of pseudarthrosis of the humeral diaphyseal intramedullary nailing provided adequate fixation and early motion, satisfying clinical, radiological and functional results are obtained. © 2012 OMU.