상완골 간부 골절 불유합의 수술적 치료

Abstract

Purpose: To analyze the cause of humerus shaft fracture nonunion in a retrospective study and describe the treatement method according to the cause. Materials and Methods: 17 cases of humerus shaft fracture nonunion available for more than 1 year follow up, were evaluated using hospital record, radiographic examination. Cause of nonunion and secondary operation method were analyzed with evaluation of bone union Results: Primary operation methods were plate fixation in 13 cases, external fixation in 2 cases, intramedullary nailing in 1 case and screw fixation in 1 case. Causes of nonunion were bone defect due to severe comminuted fracture in 11 cases, faliure of implants in 4 cases and infection in 3 cases. For treatment of nonunion, bone graft was done in all of the cases. 11 cases were operated using plate refixation, in situ bone graft in 4 cases, intramedullary nailing in 1 case and external fixation in 1 case. All of the cases achieved the bone union. Conclusion: In humerus shaft fractures, accurate procedure and appropriate fixator selection should be made to prevent nonunion. In the case of nonunion, rigid fixation and sufficient bone graft is required for satisfying result.

Key words: Humerus fracture, Nonunion, Operative treatment