Objective: To assess results of exchange nailing in nonunion after intramed
ullary (IM) nailing of humeral shaft fractures,
Methods: This was a retrospective study; 24 patients with nonunion after IM
nailing of humeral shaft fractures mere reviewed, In 13 cases, nonunion wa
s treated using exchange nailing, and 11 patients were treated nonoperative
ly. Union was assessed from radiographs. Shoulder joint symptoms and functi
on were assessed after a mean 4.7 years' follow-up using Constant-Murley sc
oring and self-administered questionnaires devised by L,'Insalata et al.
Results: Single or repeated exchange nailing resulted in union in 6 of 13 p
atients. Shedder joint function was satisfactory (mean Constant-Murley scor
e of 72) for those patients whose fracture eventually united and poor (mean
Constant-Murley score of 39) for those left with nonunion,
Conclusion: Exchange nailing results in a poor union rate in nonunion after
IM nailing of humeral shaft fractures, Permanent nonunion of the humeral s
haft leaves the patient with severe disability.