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Primary Causes and Treatment of Nonunion of the Humeral Shaft Fracture
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Soo Kyoon Rah, Hoon Choi, You Sung Suh, Byung Ill Lee, Yon Il Kim
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J Korean Soc Fract 2000;13(4):952-959. Published online October 31, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.4.952
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 Abstract
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An analysis of primary causes and treatment of the nonunion of humeral shaft fracture.
MATERIALS AND METHODS
Incidence of nonunion of humeral shaft fracture among the 183 cases was 10.4%. Among 19 cases of nonunion of humeral shaft fracture from March 1994 to December 1999, 14 cases were men and 11 cases were in third to fifth decade. The causes of the fracture were mainly due to motor vehicle accident and machinery injury. The most common site of nonunion in humeral shaft was at middle 1/3 in 10 cases.
RESULTS
Underlying causes of nonunion were complex ; 9 cases of inadequate plate internal fixation, 2 cases of infection, 6 cases of poor external immobilization and 7 cases of over distraction and soft tissue interposition. Bony union was obtained by compression plate, intra medullary nail, and external fixator with autogenous bone graft in 3.5months. Post-operative complications were radial nerve palsy in 4 cases and elbow and shoulder joint contracture in 6 cases.
CONCLUSIONS
The main factors that influence the development of humeral nonunions were over distraction of the fracture, inadequate internal fixation, and infection. We should consider that enough operative exposure, the proper choice of plate and screw depending on the bone contour and fracture site, adequate period of immobilization, and rigid fixation in internal plate fixation. It is also recommanded that interposed soft tissue be removed for anatomical reduction. Union was obtained in all cases .
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Bilateral Salter-Harris Type II Proximal Tibial Epiphtyseal Fracture: A Case
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Byung Ill Lee, Hoon Choi, You Sung Suh, You Il Kim, Soo Kyoon Rah, Chang Uk Choi
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J Korean Soc Fract 2000;13(2):252-257. Published online April 30, 2000
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DOI: https://doi.org/10.12671/jksf.2000.13.2.252
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Abstract
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- An uncommon fracture of the proximal tibial epophysis can be classified into 5 types based in the mechanism of injury and the relationship of the fracture line to the physeal plate. The separation extends along the physeal plate and then through a portion of the metaphysis, Salter-Harris type II is the most common physeal fracture. We experienced a very rare case of bilateral flexion type Salter-Harris type II fracture of the proximal tibia, which was treated by long leg cast. At six weeks fusion is complete at the proximal tibial epiphyses of both knees, and the range of motion is full at follow-up six months
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