{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:31:24Z","timestamp":1787142684513,"version":"build-2736575974"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n OBJECTIVE:<\/jats:title>\n To examine the clinical outcomes of one-stage repair for infected humeral nonunion following failed prior ORIF.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Design: Retrospective study<\/jats:p>\n <\/jats:sec>\n \n Settings:<\/jats:title>\n Tertiary referral hospital<\/jats:p>\n <\/jats:sec>\n \n Patients Selection Criteria:<\/jats:title>\n Included were patients with infected humeral nonunion after an initial fixation of fracture, who underwent surgical repair at the study site between 2016-2024.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Primary outcomes were union, infection eradication, number of surgeries, and duration of antibiotic therapy.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Fifteen patients (80% male) who underwent humeral nonunion repair surgery, with positive intraoperative cultures were included. The mean age was 48.1 years (range 26\u201370) and 80% were male. Two patients (13.3%) were active smokers, and two (13.3%) had diabetes mellitus. Nine (60%) patients sustained OTA\/AO type 12 fractures, four (26.7%) type 11 fractures, and two (13.3%) type 13 fractures. Twelve (80%) had closed fractures and 3 (20%) had open fractures. The most common initial fixation was plate and screw fixation (n=11, 73.3%), followed by intramedullary nail (n=4, 26.7%). Inflammatory markers were normal in seven patients (46.7%), elevated in three (20%), and unavailable in five (33.3%).<\/jats:p>\n A one-stage infected nonunion repair was planned for all cases (100%), with plate and screws (n=13, 86.7%), or intramedullary nailing (n=2, 13.3%). Bone graft was used in 13 (86.7%) cases and local antibiotics in two (13.3%). Cutibacterium acnes grew in 80% of cultures, followed by Staphylococcus aureus (13.3%) and Staphylococcus epidermidis (6.7%).<\/jats:p>\n Thirteen patients (86.7%) achieved union. In 10 cases (66.7%), the index single-stage repair was sufficient to achieve union, while 3 cases required additional interventions to achieve union. Mean antibiotic treatment duration was 8.1 months (SD 7.1 months, range 1.2\u201326.4). Two patients (13.3%) developed recurrent infection, and five patients (33.3%) required unplanned reoperations to promote union or treat infection.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n This study found a high ultimate union rate (86.7%) for one-stage infected humeral nonunion repair after prior failed osteosynthesis although 1 in 3 patients required unplanned reoperation for recurrent infections or recalcitrant nonunion.<\/jats:p>\n Level of Evidence Therapeutic level IV study<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003264","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:00:32Z","timestamp":1787140832000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of One-Stage Infected Humerus Nonunion Repair in Patients with Prior Operative Fracture Fixation"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0859-6019","authenticated-orcid":false,"given":"Alona","family":"Katzir","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E","family":"Bilodeau","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"},{"name":"University of Pittsburgh, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishabh S","family":"Bhadouriya","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam H","family":"Kantor","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Schlauch","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig E","family":"Klinger","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J","family":"Page","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M","family":"Ricci","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,19]]},"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:00:33Z","timestamp":1787140833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000003264","relation":{},"ISSN":["0890-5339","1531-2291"],"issn-type":[{"value":"0890-5339","type":"print"},{"value":"1531-2291","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}