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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2019030530
pages 11-17

Rupture of an Intramedullary Elastic Bundle Nail Following Humeral Shaft Nonunion: A Case Report

Nicola Corradi
Department of Morphology, Experimental Medicine and Surgery, Azienda Ospedaliero-Univeristaria di Ferrara–Arcispedale Sant'Anna, University of Ferrara, Italy
Gaetano Caruso
Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant'Anna, University of Ferrara, Italy
Ilaria Martini
Department of Morphology, Experimental Medicine and Surgery, Azienda Ospedaliero-Univeristaria di Ferrara–Arcispedale Sant'Anna, University of Ferrara, Italy
Leo Massari
Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant'Anna, University of Ferrara, Italy

ABSTRACT

A 77-year-old woman reported a spiral right humeral shaft fracture, which was treated by closed reduction and fixation with elastic bundle retrograde intramedullary nail. Despite a proper closed reduction and a minimally invasive surgery obtained, nonunion arose. The patient refused the advised second surgical treatment. At 12 months, the patient was admitted to our department as a consequence of persistent pain and unnatural humeral shaft mobility. New X-ray imaging highlighted intramedullary nail rupture due to excessive implant mobility at the nonunion site. Consequently, nail removal was performed, and plate and screws were then fixed, and a bone allograft was placed to allow fracture healing and proper stabilization. The literature reports optimal outcomes with elastic bundle intramedullary nailing. It is strongly suggested to obtain a closed reduction and minimally invasive dynamic fixation. Nonetheless, it may lead to several complications such as nonunion, for which surgical treatment is technically demanding and highly invasive.

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