Acta Orthop Belg. 2024 Mar;90(1):102-109. doi: 10.52628/90.1.11809.
In 2020, the most common treatment for presumed aseptic non-union of the humeral shaft seems to be decortication, often associated with bone autografting, and stabilized by a screw plate. We propose to evaluate an original technique of rigid osteosynthesis combining intramedullary nailing and screw plate. Between January 2004 and January 2020, 45 patients underwent treatment of presumed aseptic non-union of the humeral shaft by osteosynthesis combining intramedullary nailing and a screw plate. The minimum radio-clinical follow-up was one year postoperatively. The series included 19 men and 26 women with a mean age of 53 years (range 19-84 years). Bone consolidation was achieved in 43 patients, a rate of 95.5%. Comparing patients who achieved bone consolidation with the two failed consolidations did not reveal any statistically significant factor. Interobserver agreement was almost perfect (k=0.93) for the use of the RUST for humeral shaft fractures treated with intramedullary nailing and screw plate. In our study, the treatment of presumed aseptic non- union of the humeral shaft with an osteosynthesis combining intramedullary nailing and screw plate gives, with 95.5% of bone consolidation, results equal to or even superior to the different treatments currently described in the literature.
2020 年，肱骨干疑似无菌性不愈合的最常见治疗方法似乎是骨皮质切除术，通常与骨自体移植联合应用，并通过钢板螺钉固定。我们提出评估一种结合髓内钉和钢板螺钉的刚性骨内固定的原始技术。2004 年 1 月至 2020 年 1 月期间，45 例肱骨干疑似无菌性不愈合患者接受了结合髓内钉和钢板螺钉的骨内固定治疗。术后最少随访 1 年。该系列包括 19 名男性和 26 名女性，平均年龄 53 岁（19-84 岁）。43 例患者实现了骨愈合，愈合率为 95.5%。比较骨愈合患者与 2 例未愈合患者，未发现任何具有统计学意义的因素。采用 RUST 评估肱骨干骨折经髓内钉和钢板螺钉治疗的观察者间一致性几乎为完美（k=0.93）。在我们的研究中，结合髓内钉和钢板螺钉的骨内固定治疗肱骨干疑似无菌性不愈合，其骨愈合率为 95.5%，结果与目前文献中描述的不同治疗方法相当，甚至更优。
