Khoảng 10% các gãy xương dài xương trong xương cánh tay xảy ra. Mặc dù chính IS Điều trị thành công Thông thường, cánh tay nonunion có thể dẫn đến đánh dấu-mắc bệnh và hạn chế chức năng. Các biến chứng bao gồm co chung của vai và khuỷu tay, đặc biệt là với nonunions periarticular. | Advances in the Management of Humeral Nonunion David . Pugh MD FRCSC and Michael D. McKee MD FRCSC Abstract Approximately 10 of all long-bone fractures occur in the humerus. Although primary treatment usually is successful humeral nonunion can lead to marked morbidity and functional limitation. Complications include joint contractures of the shoulder and elbow especially with periarticular pseudarthrosis. Marked osteopenia or bone loss or both often occur after fracture and after failure to achieve union. Retained implants often break impeding fixation and requiring removal. Soft-tissue deficits and incisions from the original injury or prior surgeries also may complicate reconstruction as can intra-articular fractures and associated nerve palsies. Successful surgical management of humeral nonunion requires stable internal fixation that allows early joint motion and uses autogenous bone graft to promote healing. Contracture release and early joint motion are necessary to optimize function. Shoulder hemiarthroplasty and semiconstrained total elbow arthroplasty are viable options for irreversible joint damage. Advances in preoperative evaluation and surgical reconstruction have improved functional outcomes. J Am Acad Orthop Surg 2003 11 48-59 Approximately 10 of all long-bone fractures occur in the An increasing number of these injuries are insufficiency or fragility fractures secondary to osteoporosis a result of the rise in age of the general population. Despite advances in the initial management of these fractures some result in nonunion requiring further intervention. The factors that contribute to the incidence of nonunion include patient age mechanism of injury initial treatment presence of concomitant injuries nutritional status and a history of Because treatment is time consuming and difficult successful initial fracture management is important. Most humeral shaft fractures can be treated nonsurgi-cally with a high rate of union. .
