InSafeLOCK® humeral nailing for humeral nonunions: Clinical and radiological results

Abstract

Objectives: This study aims to evaluate the clinical and functionalresults of patients treated with InSafeLOCK® humeral nail andiliac crest autograft for humeral nonunion.Patients and methods: A total of 15 patients (11 males, 4 females;mean age: 52.1±15.3 years; range, 31 to 78 years) who werefollowed conservatively for humeral fractures and operatedwith the InSafeLOCK® humeral nail and iliac bone graft in ourcenter between June 2018 and January 2020 were retrospectivelyanalyzed. Data including demographic and clinical characteristicsof the patients, operative data, and pre- and postoperative VisualAnalog Scale (VAS), Disabilities of the Arm, Shoulder, and Hand(DASH), and Constant-Murley Scores (CMS) were recorded.Results: The mean time from injury to nonunion treatmentwas 10.9±1.6 months. Five patients had atrophic, eight patientshad oligotrophic, and two patients had hypertrophic nonunion.Preoperatively, the mean DASH was 37.7±9.1, the mean CMS was69.7±6.3, and the mean VAS was 3.8±0.7. In all patients, unionwas achieved. The mean operation time was 59.0±16.2 min. Themean postoperative DASH score was 16.1±8.7, CMS 87.4±3.4,and VAS score 0.8±0.7. Regarding the shoulder joint, the meanabduction was 164.7±11.3 degrees, the mean internal rotation was82.0±6.8 degrees, the mean external rotation was 81.3±8.3 degrees,and the mean flexion was 162.0±12.1 degrees. During follow-up,complications such as vascular-nerve injury, reflex sympatheticdystrophy, screw migration or loosening, implant failure, and lossof reduction did not occur in any of our patients.Conclusion: Considering the satisfactory functional andradiological results, the InSafeLOCK® humeral nail can be usedsafely in humeral nonunions.