Treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone graft

Abstract

Background: This study was conducted to evaluate the treatment of aseptic nonunion of the humeral shaft with a dynamic compression plate (DCP) and cancellous bone graft.

Methods: One hundred and five cases of nonunion of a humeral shaft fracture between 1982 and 2001 were analyzed retrospectively. The study population comprised 66 males and 39 females with an average age of 46.2 years (range, 17-81 years). Sixty-seven fractures were defined as atrophic nonunion, and 20 as hypertrophic nonunion, whereas 18 could not be defined clearly. All the fractures were managed by open reduction and internal fixation with DCP and cancellous bone graft. The mean follow-up period was 20 months (range, 14-28 months).

Results: All nonunion fractures united within an average of 16 weeks (range, 10-26 weeks). Complications included 4 patients with temporary radial-nerve palsies, and 3 patients with wound infections. At the final follow-up, shoulder and elbow functions of the operated limbs were all satisfactory.

Conclusion: Fixation by DCP with supplemental cancellous bone graft is a reliable and effective treatment for nonunion of a humeral shaft fracture.