Locking compression plate fixation in humeral shaft fractures: A comparative study to literature conservative treatment.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that they have no conflict of interest. 20. Indian J Orthop. 2023 Jan 26;57(4):552-564. doi: 10.1007/s43465-023-00819-4. eCollection 2023 Apr. Consistent Protocol-Based Management of Humerus Shaft Nonunion: An Analysis of 100 Cases. Dheenadhayalan J(1)(2), Vembanan K(1), Devendra A(1), Perumal R(1), Nagashree V(1), Kumar AH(1), Rajasekaran S(1). Author information: (1)Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt. Ltd, 313, Mettupalayam Road, Coimbatore, Tamil Nadu India. (2)No.3, Gandhinagar, Behind Cheran Nagar, GN Mills Post, Coimbatore, 641029 Tamil Nadu India. INTRODUCTION: Humerus shaft nonunions are very disabling and challenging to treat. The current study aims to analyse the rate of union and the incidence of complications following a consistent protocol in treating humerus shaft nonunion. METHODOLOGY: We did a retrospective analysis of 100 patients with humerus shaft nonunion treated over an eight-year period from 2014 to 2021. The mean age was 42 years (range 18-75 years). There were 53 male and 47 female patients. The average time interval from injury to nonunion surgery was 23 months (range 3 months to 23 years). The series included 12 recalcitrant nonunions and 12 patients with septic nonunion. All patients underwent freshening of fracture edges to increase the contact surface area, stable fixation with a locking plate and intramedullary iliac crest bone grafting. Infective nonunions were treated in a staged manner, following a similar treatment protocol after the elimination of infection in the first stage. RESULTS: Complete union was achieved in 97% of the patients with a single procedure. One patient achieved union after an additional procedure, while two patients were lost to further follow-up. The mean time to union was 5.7 months (range 3-10 months). Three patients (3%) had postoperative radial nerve palsy, which recovered completely within 6 months. Three patients (3%) had a superficial surgical site infection, while one patient (1%) developed a deep infection. CONCLUSION: Intramedullary cancellous autologous grafts combined with stable fixation by compression plating achieve a high union rate with minimal complications. LEVEL OF EVIDENCE: III. LEVEL OF CLINICAL CARE: Level I Tertiary trauma centre. © Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. DOI: 10.1007/s43465-023-00819-4 PMCID: PMC10050540