title: Recalcitrant posttraumatic nonunion of the humerus: 23 patients reconstructed with vascularized bone graft.
abstract: We treated 23 patients with recalcitrant posttraumatic humeral shaft nonunion with vascularized bone grafts (fibula 10, femur 10 and scapula 3). 21/23 patients healed primarily. Venous thrombosis in the graft necessitated postoperative thrombectomy in 2 patients. Complications at the donor site were trivial. We used a vascularized fibular graft in patients with a large bone defect and with poor intrinsic stability of the nonunion site and a corticoperiosteal femoral graft in atrophic nonunion without a substantial bone defect. The scapula graft is easy to transfer to the surgical neck of the humerus on its pedicle.
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. muramatu@po.cc.yamaguchi-u.ac.jp
authors.forename: Keiichi
authors.initials: K
authors.lastname: Muramatsu
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Doi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ihara
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Shigetomi
authors.forename: Shinya
authors.initials: S
authors.lastname: Kawai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D005260:Female; D005593:Fracture Fixation, Internal; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D017211:Treatment Failure