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Related Concept Videos

Bones of the Upper Limb: Humerus01:19

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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Bones of the Upper Limb: Ulna01:15

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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Related Experiment Video

Updated: Dec 19, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
04:41

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner

Published on: June 6, 2025

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Distal humerus nonunion: evaluation and management.

Frédéric Vauclair1, Patrick Goetti1, Ngoc Tram V Nguyen2

  • 1Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

EFORT Open Reviews
|June 9, 2020
PubMed
Summary

Distal humerus nonunion occurs in 8-25% of cases. While internal fixation shows high union rates, managing modifiable risk factors and addressing complications are crucial for successful outcomes.

Keywords:
arthroplastydiagnosisdistal humeruselbowinfectioninternal fixationnonuniontreatment

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Bone Healing

Background:

  • Distal humerus nonunion remains a challenge despite surgical advancements, occurring in 8-25% of cases.
  • Identifying and managing modifiable risk factors (smoking, metabolic disorders, immunosuppression, nutrition, infection) is essential.
  • Computed tomography (CT) is vital for assessing nonunion patterns, bone stock, hardware, and articular surface integrity.

Purpose of the Study:

  • To review current treatment strategies for distal humerus nonunion.
  • To highlight the importance of risk factor management and diagnostic imaging.
  • To compare internal fixation and total elbow arthroplasty for nonunion management.

Main Methods:

  • Literature review of distal humerus nonunion treatments.
  • Analysis of diagnostic modalities, including computed tomography (CT).
  • Comparison of surgical techniques: internal fixation versus total elbow arthroplasty.

Main Results:

  • Internal fixation is preferred for patients with adequate bone stock and preserved cartilage, achieving over 95% union rates.
  • Total elbow arthroplasty is a viable option for severe articular destruction or bone loss, particularly in older female patients.
  • Despite high union rates, internal fixation is associated with significant complications and potential for unsatisfactory results.

Conclusions:

  • Successful management of distal humerus nonunion requires meticulous risk factor optimization and appropriate surgical selection.
  • Internal fixation, while effective for union, necessitates careful attention to fixation stability, contracture release, and bone grafting.
  • Total elbow arthroplasty offers an alternative for complex cases with extensive joint damage, though outcomes require further investigation.