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Images
  • summary
  • Epidemiology
  • Etiology
  • Anatomy
  • Presentation
  • Imaging
  • Studies
  • Treatment
    • Nonoperative
      • functional bracing +/- bone stimulation
        • indications
          • rarely indicated unless low demand, high-risk surgical candidate, and asymptomatic nonunion
        • modalities
          • continued functional brace
          • bone stimulators
            • nonunion over a period greater than 9 months or no progressive healing 3 months from injury
            • contraindicated if pseudarthrosis, fracture gap >5mm, or poor blood supply
    • Operative
      • compression plating with bone grafting (gold standard)
        • indications
          • symptomatic nonunion
        • outcomes
          • shown to be superior to IM nailing
      • dual plating
        • indications
          • very proximal or distal fracture nonunion
          • poor metaphyseal bone quality
          • micromotion noted at fracture site following single plate fixation
        • outcomes
          • 92-100% union at 16 weeks
      • cortical strut allograft/autograft
        • indications
          • severe osteopenia from disuse, age, or prior surgery
          • severe bone loss
          • recalcitrant nonunion
        • outcomes
          • 95-100% union rate
      • bone morphogenic proteins (BMP's)
        • indications
          • limited role as no studies show improved outcomes
  • Techniques
  • Complications
  • Prognosis
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Trauma⎪Humeral Shaft Nonunion
  • Trauma
  • - Humeral Shaft Nonunion
17:25 min
1/14/2020
879 plays
4.6
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