Yonsei Med J.  2017 Jul;58(4):837-841. 10.3349/ymj.2017.58.4.837.

Do Cerclage Cables Delay the Time to Bone Union in Patients with an Unstable Humeral Shaft Fracture Treated with Intramedullary Nails?

• Han KJ
• Lee DH
• Bang JY

• KMID: 2419092
• DOI: http://doi.org/10.3349/ymj.2017.58.4.837

Abstract

PURPOSE
To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures.
MATERIALS AND METHODS
Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64). The length of time to bone union and functional scores [Disabilities of the Arm, Shoulder and Hand (DASH) and University of California, Los Angeles (UCLA) scores] were measured for all patients.
RESULTS
No significant differences were found in terms of age, gender, injury type, or smoking history between the two groups, except for the type of fracture. The cable group had significantly more complex types of fracture than the non-cable group (p<0.001). The mean time to bone union was 3.9 months in the cable group, while in the non-cable group, it was 4.4 months (p=0.041). The incidence of postoperative complications, such as non-union, delayed union, and radial nerve palsy, was similar between the two groups (p>0.05). No differences were identified in terms of DASH and UCLA scores (28.8 and 32.1 in the cable group and 26.4 and 32.6 in the non-cable group, respectively; p=0.335 and 0.264).
CONCLUSION
In unstable humeral shaft fractures treated by IMN, open reduction and internal fixation with additional cerclage cables do not delay the length of time to bone union or increase the rate of other complications.

Keyword

Humeral fractures; cerclage; cables; fracture fixation; intramedullary nail

MeSH Terms

Adolescent
Adult
Aged
*Bone Nails
Female
Fracture Fixation, Intramedullary/adverse effects/*methods
Humans
Humeral Fractures/*surgery
Male
Middle Aged
Operative Time
Postoperative Complications/etiology
Time Factors
Treatment Outcome
Young Adult

Figure

• 

  Fig. 1 (A and B) A 29-year-old man with an OTA/AO type-B2 right humeral shaft fracture after a slip down event. Open reduction and internal fixation of the fragments with two cerclage cables followed by intramedullary nailing was performed. (C and D) A radiograph taken 4.5 months after surgery shows bone union. OTA, Orthopaedic Trauma Association.

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