title: Treatment of surgical neck nonunions of the humerus with locked plate and autologous fibular strut graft.
abstract: OBJECTIVE
  To determine whether using a fixed-angle locked plate plus a fibular strut autograft to treat humeral surgical neck nonunions can result in improved union.
  
  
  METHODS
  The study cohort included 5 females and 2 males with an average age of 58.4 years (range 45-76) who presented with atrophic nonunion of the surgical neck of the humerus. All patients underwent revision surgery with locked plating plus a nonvascularized autologous fibular strut bone graft. Clinical and radiological union was documented in all patients.
  
  
  RESULTS
  The mean time from initial trauma to last revision surgery was 20.1 ± 12.6 months (range 12-48). The average time between revision surgery and the date of union was 6.1 months (range 5-8). The average active forward flexion was 124° (range 70-160) at final follow-up. The Constant-Murley score increased from an average of 25.7 points preoperatively to 77.7 points postoperatively (p < 0.001). The average analog scale of pain decreased from 7.57 points (range 6-10) preoperatively to 0.57 points (range 0-2) postoperatively (p < 0.001).
  
  
  CONCLUSIONS
  Locked plate fixation and autologous fibular strut bone graft facilitated the successful treatment of humeral surgical neck nonunions.
authors.affiliation: Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, PR China.
authors.forename: Kanda
authors.initials: K
authors.lastname: Gao
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Jianhua
authors.initials: J
authors.lastname: Huang
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wu
authors.forename: Chuan Shun
authors.initials: CS
authors.lastname: Wang
authors.forename: Qiugen
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005360:Fibula / Q000601:surgery* / Q000637:transplantation*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies