Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Jan;98-B(1):81-7.
doi: 10.1302/0301-620X.98B1.35682.

Treatment of nonunions in fractures of the humeral shaft according to the Diamond Concept

M Miska  1 , S Findeisen  1 , M Tanner  1 , B Biglari  2 , S Studier-Fischer  2 , P A Grützner  2 , G Schmidmaier  1 , A Moghaddam  1
Affiliations
Multicenter Study

Treatment of nonunions in fractures of the humeral shaft according to the Diamond Concept

M Miska et al. Bone Joint J. 2016 Jan.

Abstract

Methods: Between 2005 and 2012, 50 patients (23 female, 27 male) with nonunion of the humeral shaft were included in this retrospective study. The mean age was 51.3 years (14 to 88). The patients had a mean of 1.5 prior operations (sd 1.2;1 to 8). All patients were assessed according to a specific risk score in order to devise an optimal and individual therapy plan consistent with the Diamond Concept. In 32 cases (64%), a change in the osteosynthesis to an angular stable locking compression plate was performed. According to the individual risk an additional bone graft and/or bone morphogenetic protein-7 (BMP-7) were applied.

Results: A successful consolidation of the nonunion was observed in 37 cases (80.4%) with a median healing time of six months (IQR 6). Younger patients showed significantly better consolidation. Four patients were lost to follow-up. Revision was necessary in a total of eight (16%) cases. In the initial treatment, intramedullary nailing was most common.

Discussion: The use of locking compression plates in combination with autologous cancellous bone graft has been shown to be a safe and effective treatment. In more complex cases, the use of the Masquelet technique and BMP-7 may be indicated at the first revision operation.

Take home message: Our results suggest the Diamond Concept is a successful treatment strategy for nonunions of the humeral shaft.

Keywords: Diamond Concept; Fracture Healing; Fracture of the Humeral Shaft; Nonunion; Pseudoarthrosis.

PubMed Disclaimer