Nonunion after intramedullary nailing of humeral shaft fracture

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.