ABSTRACT
Objective To discuss the effects and methods of the surgical treatment of complex humeral nonunion.Methods Ten cases of scleroid humeral nonunion were treated by compressive interlocking medullary nailing and autografting of iliac bone.Fifteen cases of humeral nonunion combined with osteomyelitis or osteoporosis were treated with grafting of free vascularized fibular flaps.Results All the cases were followed up for six months to six years.They all obtained bone union.The average time of bone union was 3.1 months for the free vascularized fibular grafting group and 3.8 months for the interlocking medullary nail group.Conclusions Compressive interlocking medullary nailing and autografting of iliac bone is effective for scleroid humeral nonunion,while grafting of free vascu- larized fibular flaps is effective for humeral nonunion combined with osteomyelitis or osteoporosis because the free vas- cularized fibular grafting can well reconstruct the defective humerus bone with osteoporosis or osteomyelitis.