Treatment of surgical neck nonunions of the humerus with locked plate and autologous fibular strut graft

ABSTRACT

To determine whether using a fixed-angle locked plate plus a fibular strut autograft to treat humeral surgical neck nonunions can result in improved union. Patients and Methods: The study cohort included 5 females and 2 males with an average age of 58.4 years [range 45-76] who presented with atrophic nonunion of the surgical neck of the humerus. All patients underwent revision surgery with locked plating plus a nonvascularized autologous fibular strut bone graft. Clinical and radiological union was documented in all patients. The mean time from initial trauma to last revision surgery was 20.1 +/- 12.6 months [range 12-48]. The average time between revision surgery and the date of union was 6.1 months [range 5-8]. The average active forward flexion was 124° [range 70-160] at final follow-up. The Constant-Murley score increased from an average of 25.7 points preoperatively to 77.7 points postoperatively [p < 0.001]. The average analog scale of pain decreased from 7.57 points [range 6-10] preoperatively to 0.57 points [range 0-2] postoperatively [p < 0.001]. Locked plate fixation and autologous fibular strut bone graft facilitated the successful treatment of humeral surgical neck nonunions