Revision with dynamic compression plate and cancellous bone graft for aseptic nonunion after surgical treatment of humeral shaft fracture

Abstract

Background: We evaluated the effect of revision with dynamic compression plate (DCP) and cancellous bone graft for aseptic nonunion after surgical treatments of humeral shaft fracture.

Method: Eighty-six patients with aseptic nonunion of humeral shaft fracture after various surgical treatments were reviewed and analyzed retrospectively between January 1982 and August 2006. There were 59 men and 27 women with the average age of 42 years (range, 19-81 years). Thirty-one fractures were defined as atrophic nonunion, 45 fractures were hypertrophic nonunion, and 10 fractures could not be defined clearly. All the fractures were managed with removal of previous implants, open reduction and internal fixation with DCP, supplemented by cancellous bone graft. The follow-up period was 38 months in average (range, 12-288 months). Functional evaluations were done by Mayo Elbow Performance Index and the modified scale of Constant and Murley.

Results: All the nonunions united with the average union time of 18 weeks (range, 14-26 weeks). Complications included five temporary radial nerve palsies and two wound infections. In final follow-up, the shoulder and elbow functions of the operated limbs were all noted to be good or excellent.

Conclusion: DCP with cancellous bone graft is a reliable and an effective treatment for revision of aseptic nonunion of humeral shaft fracture after surgical treatment.