Humeral shaft nonunion treated by a Seidel interlocking nail with a supplementary staple.

Thirty-two adult patients with humeral shaft nonunions were treated with Seidel interlocking nails, and 6 of these 32 patients required an added staple. The indication for inserting a staple was rotational instability, despite use of a distal spreading screw. All 6 patients with nonunions were followed for at least 1 year (median, 1.5 years), and all experienced a solid union. The union period was a median of 5 months, with a range of 3 to 7 months. No complications were noted. The author believes that all humeral shaft nonunions may be treated by a Seidel interlocking nail with or without a staple supplementation and cancellous bone graft. The technique is simple, and its results are satisfactory. Predrilling the cortices of both fragments is key to successful insertion of a staple.