Humeral shaft nonunion: evaluation of uniform surgical repair in fifty-one patients.
OBJECTIVE
To determine whether a standardized treatment of aseptic humeral shaft nonunions results in union after one operation without substantial complications.


METHODS
Retrospective study.


METHODS
University hospital.


METHODS
Between 1975 and 1998, fifty-eight patients sustained a humeral shaft fracture that resulted in an aseptic nonunion. Fifty-one patients between the ages of twenty-three and eighty-six years (mean 50.8 years) were included and evaluated.


METHODS
Surgical treatment consisted of an anterolateral approach with radial nerve identification and subsequent neurolysis, decortication, compression plating, and frequent application of autogenous bone grafts. No immobilization with brace or cast after treatment was functional.


METHODS
Success rate of nonunion repair, reinterventions, complications, range of motion, patient satisfaction.


RESULTS
After one year, consolidation was apparent in all cases. All but two patients had an essentially normal range of motion of the shoulder and elbow, and 96 percent rated their result as excellent or good. After nonunion repair, two patients had a transient sensory neuropathy of the radial nerve. In one patient, a second intervention was needed after a fall from bed one week after the index operation.


CONCLUSIONS
The results of this study indicate that our standard surgical procedure for treatment of nonunion of the humeral shaft is reliable and achieves consolidation in one procedure without significant complications.
Marti
R K
RK
Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Verheyen
C C P M
CC
Besselaar
P P
PP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D016025:Bone Transplantation; D005260:Female; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome