{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:48:06Z","timestamp":1791917286291,"version":"4.3.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Chengdu Medical Research Projects","award":["2022166"],"award-info":[{"award-number":["2022166"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Nonunions of humeral surgical neck fractures (HSNF) are rare and complex problems. This study aimed to evaluate the clinical and functional outcomes of antegrade straight interlocking intramedullary nail (ASIIN) combined with autogenous iliac crest bone graft (ICBG) for treating nonunions of HSNF and to analyze the impact of initial treatment on nonunion repair outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients with nonunions of HSNF treated with ASIIN combined with autogenous ICBG at our institution. Patients were divided into two groups based on initial treatment: primary nonunion group or secondary revision of internal fixation group. All patients were followed up for a minimum of 2 years. Outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) pain score, and shoulder range of motion (ROM). Statistical analyses were performed to compare outcomes before and after nonunion repair and between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between June 2014 and May 2022, 29 patients with HSNF nonunions treated with ASIIN combined with autogenous ICBG were included in the study. The cohort comprised 11 patients initially treated conservatively and 18 patients who initially underwent locking plate fixation. Union was achieved in all patients at a mean of 5.6 months post-repair. At the final follow-up, significant improvements were observed in mean ASES scores, VAS pain scores, and active shoulder ROM compared to preoperative values. However, no significant differences were noted between the two groups. The mean union time was significantly shorter in the primary nonunion group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ASIIN combined with autogenous ICBG provides stable fixation and an active biological environment, offering an effective treatment for complex HSNF nonunions. Although initial treatment modality did not significantly affect clinical outcomes, patients initially treated conservatively achieved union faster than those treated surgically.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261496398","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:24:25Z","timestamp":1791915865000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of antegrade straight interlocking intramedullary nail combined with autogenous iliac crest bone graft in the treatment of nonunions of humeral surgical neck fractures at a minimum 2 years\u2019 follow-up"],"prefix":"10.1177","volume":"34","author":[{"given":"Hang","family":"Chen","sequence":"first","affiliation":[{"name":"Sichuan Provincial Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochuan","family":"Hu","sequence":"additional","affiliation":[{"name":"Sichuan Provincial Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-3812","authenticated-orcid":false,"given":"Huihui","family":"Wang","sequence":"additional","affiliation":[{"name":"Sichuan Provincial Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"9","key":"e_1_3_4_2_2","first-page":"538","article-title":"Proximal humerus and humeral shaft nonunions [published correction appears in J Am Acad Orthop Surg. 2013 Nov;21(11):21a]","volume":"21","author":"Cadet ER","year":"2013","unstructured":"Cadet ER, Yin B, Schulz B, et al. Proximal humerus and humeral shaft nonunions [published correction appears in J Am Acad Orthop Surg. 2013 Nov;21(11):21a]. 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Pseudarthrosis: pathophysiology, biomechanics, therapy, results. Grune & Stratton, 1976, pp. 14\u201328."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199012000-00011"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00405"},{"issue":"11","key":"e_1_3_4_14_2","first-page":"S174","article-title":"Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI)","volume":"63","author":"Angst F","year":"2011","unstructured":"Angst F, Schwyzer HK, Aeschlimann A, et al. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). 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