title: [Treatment of recalcitrant humeral nonunion in elderly patients].
abstract: BACKGROUND
  Humeral nonunion that persists through various unsuccessful attempts at management, presents a real challenge. When combined with severe osteoporosis in elderly patients, the problems only increase. This study aims to investigate the best option for treating this combination of factors.
  
  
  METHODS
  This study analyses the outcomes of five patients with the following inclusion criteria: nonunion of the humeral diaphysis, after at least two unsuccessful interventions and/or after a period of 18 months or more, associated with severe osteoporosis in patients aged over 65. All cases were treated by debridement of the site of nonunion and stabilisation with locking plates and bone graft.
  
  
  RESULTS
  All cases consolidated after a mean follow-up period of 19 months (8-36 months).
  
  
  CONCLUSIONS
  In cases of humeral nonunion in elderly patients with osteoporotic bones, locking plates have been proven to provide consistent, long-term stability, with better results than traditional compression plates. The authors consider that locking plates should be considered as a valid option in cases of extreme bone and biological instability, as is the case in recalcitrant humeral nonunion.
authors.forename: A J
authors.initials: AJ
authors.lastname: Garbayo Marturet
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario de Navarra, Pamplona, 31008, Spain. alberto.tejero.ibanez@navarra.es.
authors.forename: A
authors.initials: A
authors.lastname: Tejero Ibáñez
authors.forename: F J
authors.initials: FJ
authors.lastname: Repáraz Padrós
authors.forename: A
authors.initials: A
authors.lastname: Castaño Serrano
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000601:surgery*; D010024:Osteoporosis / Q000150:complications; D011542:Pseudarthrosis / Q000150:complications / Q000601:surgery*