Treatment of non-union of fractures of the distal end of the hummerus in adults

ABSTRACT

Thirteen cases of un-united fractures of the distal end of the humerus were treated by open reduction and internal fixation. Two cases were excluded from the study due to lack of follow up records. Eight cases were open fractures [two were fire arm injuries, six were motor care accidents], two cases were closed fractures and in the last case non- union developed after corrective osteotomy to treat cubitus varus deformity. The initial treatment was above elbow plaster cast in four patients, external fixation in three, debridement and immobilization in three and intra-medullary rod in one. Before treatment of non- union, all patients had pain, disability and stiffness of the elbow and two had discharging sinuses. Radiologically, ten were considered to have a non-reactive non- union and only one showed reactive non- union. The average time from the original fracture to the treatment of the non-union was 18 months [range from 3 to 60 months]. In all cases, double plate fixation and iliac bone graft through a posterior approach was done. At follow up [average 31.5 months], all the non- unions got united and the function was rated as excellent in two, good in seven and fair in two