{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:46:31Z","timestamp":1775709991197,"version":"3.50.1"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Non-union following humeral shaft fractures is an uncommon yet disabling complication that may ultimately lead to implant failure in the presence of persistent mechanical instability. Delayed, non-traumatic breakage of an intramedullary nail several decades after fixation is exceedingly rare.\n\nCase Report: We report the case of a 44-year-old male who presented 20 years after primary intramedullary interlocking nailing for a humeral shaft fracture with progressive arm pain, functional limitation, established mid-diaphyseal non-union, and spontaneous nail breakage in the absence of new trauma. The patient was managed with a single-stage surgical procedure comprising implant removal, thorough debridement of the non-union site, open reduction and internal fixation using compression plating, and augmentation with autogenous iliac crest bone graft. The post-operative course was uneventful, and serial radiographs demonstrated progressive healing with solid union and restoration of function.\n\nConclusion: This case highlights the importance of addressing both mechanical stability and the biological environment in the management of chronic humeral shaft non-union and supports single-stage nail removal followed by compression plating with autologous bone grafting as a reliable treatment strategy for rare late implant failures.\n\nKeywords: Humeral shaft fracture, non-union, intramedullary nail failure, nail breakage, compression plating, iliac crest bone graft.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i04.7040","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:56:00Z","timestamp":1775706960000},"page":"70-74","source":"Crossref","is-referenced-by-count":0,"title":["Twenty-year Delayed Failure of an Intramedullary Humeral Nail Due to Shaft Non-union and its Surgical Management: A Case Report"],"prefix":"10.13107","volume":"16","author":[{"given":"Akilan Narayanan","family":"Soundararajan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soundararajan","family":"Karuppanan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muthukannan Hari","family":"Sivanandan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudhir","family":"V","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vineeth B","family":"Maligi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsh Dinesh","family":"Chandak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, College-Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, University-Vinayaka Mission\u2019s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:56:15Z","timestamp":1775706975000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/04\/twenty-year-delayed-failure-of-an-intramedullary-humeral-nail-due-to-shaft-non-union-and-its-surgical-management-a-case-report\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i04.7040","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}