Implementation of locking compression plate together with intramedullary fibular graft in atrophic type humeral nonunions

Abstract
Objective This study aims to report the results of locking
compression plate along with intramedullary Wbular graft
that was implemented in patients with the diagnosis of nonunion
of humerus diaphysis.
Materials and methods Five patients, operated between
2000 and 2009 for atrophic type nonunion of humeral diaphysis,
were included in this study. Two patients were women
(40%) and three were men (60%). The mean age was
49.2 years. Nonunion was found to be on the right humerus
of 3 patients and on the left side of 2 patients. Causes of fractures
were traYc accident in 2 cases, simple fall in 2 cases,
and fall from height in 1 case. Mean duration after the elementary
fracture was 70 months. Nonunion was diagnosed at
1/3 proximal humeral diaphysis in 2 patients, 1/3 distal
humeral diaphysis in 2 patients, and 1/3 middle humeral
diaphysis in one patient. Initially, conservative treatment was
chosen for 3 cases and plate-screw osteosynthesis for 2 cases.
Results Complete union was obtained in all cases radiologically.
Mean union time was 20.1 weeks. With a mean of
1.78 cm, shortening was detected in comparative radiographies
of both humeri. Mean range of motion at the elbow was
118° in Xexion–extension arch of patients. The mean Constant-
Murley score was 88 points. There was no complication
regarding the operation and graft donor sites.
Conclusion The management of atrophic type humeral
nonunions is diYcult. The method that we practice in such
patients is a reliable treatment option with its stabile Wxation
and high union rates.
Keywords Humerus fracture · Nonunion · Surgical
treatment · Fibular allograft · Plate osteosynthesis