Anterior minimally invasive bridge-plate technique for treatment of humeral shaft nonunion.
BACKGROUND
The present study introduces a new surgical technique and the results of a case series of patients with humeral shaft nonunion.


METHODS
Fifteen patients with diagnosis of diaphyseal nonunion of humerus were operated by a bridge-plate technique. A 4.5-mm plate is slid on the anterior surface of the humerus, submuscular to the brachial muscle. With the plate over the anterior surface of the humerus, screws are inserted from anterior to posterior on the ends of the plate. When there is a small bone gap, an iliac autologous graft is inserted. Minimum follow-up was 1 year.


RESULTS
Bone healing was obtained in all patients: 1.5 months postoperatively in 11 patients, 2 months in 3 patients, and 3 months in 1 patient. There were no postoperative infections, there was one case with loosening of the screws and plate, and there were no nerve injuries.


CONCLUSIONS
The present technique avoids wide dissection, radial nerve isolation, and periosteum stripping. The anterior minimally invasive bridge-plate technique for treatment of humeral shaft nonunion is a safe procedure and obtained bone healing in all patients in this series.
Brazilian Orthopaedics and Traumatology Society-SBOT, Associação Beneficente Nossa Senhora do Pari, Hospital Nossa Senhora do Pari, Rua Hannemann, 234, São Paulo, SP, Brazil. prvjbr@ig.com.br
Paulo Roberto
PR
Vilaça
Marcelo Koh
MK
Uezumi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D055815:Young Adult