Two-Plate Fixation for Humeral Shaft Nonunions

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 17; no. 2; pp. 135 - 138
• Main Authors: Martinez, Angel Antonio, Cuenca, Jorge, Herrera, Antonio
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-08-2009; SAGE Publishing
• Subjects: bone plates; humerus
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949900901700201

Purpose.
To review 22 patients who underwent 2-plate fixation for non-union of the humeral shaft.
Methods.
13 women and 9 men aged 32 to 76 (mean, 48) years underwent fixation for non-union of the humeral shaft, using a 2-plate construct, together with decortication, debridement, and bone grafting. The two 3.5-mm reconstruction plates were parallel and lying at 90° to each other and fixed with screws purchasing into at least 6 cortices of each fragment for both plates. Fractures were located in the upper third (n=8) or middle third (n=14) of the humerus. Initial treatments included casting (n=9), coaptation splinting (n=8), multiple retrograde pinning (n=4), and Marchetti-Vicenzi nailing (n=1). 18 non-unions were atrophic and 4 were hypertrophic. Shoulder and elbow range of motion as well as functional results were evaluated.
Results.
The time for union was 4.6 (range, 4–6) months. No implants were loose or broken. No nonunion or infection was noted. Functional results were excellent in 17 and good in 5 patients. One patient had iatrogenic radial nerve palsy that recovered within 3 months.
Conclusion.
Two-plate fixation achieves good results for humeral shaft non-unions.