combination of dual bicortical onlay bone grafting and compression plating for atrophic humeral nonunion

This study was performed to evaluate the functional and radiological results of treatment of the established atrophic nonunited diaphyseal humerus fractures by the combination of compression plating and autogenous dual bicortical bone grafting, to determine whether a standardized treatment of aseptic humeral shaft nonunions results in union after one operation without substantial complications. Eleven adult patients [nine females and two males] who had been diagnosed as atrophic nonunion of humeral diaphyseal fractures were included in this study. All patients were treated by the same technique using compression plating and autogenous fixed dual bicortical bone grafting. The follow up period ranged from 12 to 18 months [average 15 months]. The functional outcome of the operative intervention was evaluated using the Stewart and Hundley [27] rating scale. Union of the fracture occurred in every case. The mean healing time was 18.6 [16-22] weeds. The range of motion of the shoulder and elbow was excellent in 8 patients, that of the shoulder moderate in 3, and, that of the elbow moderate in 2 and poor in 1. the overall functional results were excellent in 7 patients, good in 3 and fair in one case. When attempting to heal persistent nonunited fractures, multiple methods used simultaneously should be considered to increase the chance of success. Given the good functional results in this series, the combination of compression plating and dual onlay bicortical bone grafting appeared to be a good method for treating humeral shaft atrophic nonunions