HUCKSTEP INTRAMEDULLARY NAILING FOR NONUNION OF HUMERAL SHAFT FRACTURES

Background: Various techniques of internal fixation for non-union of h umeral shaft fractures have been attempted, leading to union rates of between 50 and 90% with persisting non-union causing pain and disabili ty. Some of these techniques have led to shoulder and elbow dysfunctio n. Methods: Eight patients treated with Huckstep nail fixation for hum eral shaft non-union were reviewed and the rate of union was determine d. Elbow and shoulder function were assessed as well as the presence o f pain or disability. Results: Union was achieved in seven of the eigh t patients (87.5%). Four patients had occasional mild pain after union . All patients achieved good arm function. Average shoulder abduction was 157 degrees and flexion 151 degrees excluding one patient with ant ecedent advanced osteoarthrosis of the gleno-humeral joint. No patient experienced any permanent neurological deficit. Conclusions: Huckstep nail fixation achieved union rates comparable to or higher than the o ther techniques of internal fixation for non-union of humeral shaft fr actures. Unlike the various methods of closed nailing, Huckstep nail f ixation is not associated with shoulder and elbow dysfunction. It shou ld be considered as a therapeutic option in humeral shaft fracture and non-union, especially where the fracture site needs to be opened.