[Surgical treatment of upper humerus fracture nonunion].
OBJECTIVE
To explore the clinical effects of different operative procedures in treatment of upper humerus fracture nonunion.


METHODS
From May 2001 to September 2007, 43 cases of upper humerus fractures nonunion were treated, including 31 males and 12 females with an average age of 37 years (range, 20-57 years). The causes were traffic accident injury in 14 cases, falling injury from height in 11 cases, tumbling injury in 7 cases, heavy pound injury in 6 cases, machine injury in 4 cases, and pathological injury in 1 case. The time from fracture to hospitalization was 10-52 months (23 months on average). After open reduction, patients were treated respectively by bone-graft plus locking compression plate fixation (9 cases), scapula flap rotation displacement plus locking compression plate fixation (15 cases), and scapula flap rotation displacement plus locking compression plate plus tibia bone lamella fixation (19 cases).


RESULTS
All incisions healed by first intention. The X-ray films showed good fracture reduction. No symptoms of infection and nerve injury occurred. Forty-three patients were followed up 12 to 25 months with an average of 18 months. All of them achieved radiographic union within 3.0 to 7.5 months (4.9 months on average). According to comprehensive assessing standard of X-ray film and functions of shoulder and elbow, the results were excellent in 21 cases, good in 15 cases, fair in 4 cases, and poor in 3 cases; the excellent and good rate was 83.7%.


CONCLUSIONS
In the treatment of upper humerus fractures nonunion, locking compression plate can provide stable fixation. It can achieve satisfactory results so long as the right method of bone graft is chosen according to fracture site situation. But for patients undergoing repeated surgery or having nonunion for long times and poor fracture site situation, after open reduction, scapula flap rotation displacement plus locking compression plate plus tibia bone lamella fixation has good outcome.
Zhang
Zuojun
Z
Department of Upper Limb Injury, Luoyang Orthopedic-Traumatological Hospital, Orthopedic-Traumatological Institute of Henan Province, Luoyang Henan, 471002, P.R. China. zzjlip@163.com
Li
Wenqing
W
D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055815:Young Adult