Outcome of Humeral Shaft Infected Non-Unions, Treated with Orthofix External Fixator

Abstract

BACKGROUND We wanted to review the infected non-unions of humeral shaft treated with Orthofix external fixators with regard to bone grafting, union, complications and resolution of infection. METHODS Eight men and two women with infected non-unions of humeral shaft were treated between 2003 and 2011. All patients had active pus discharge. Four injuries were closed, and the rest were open injuries. Six had internal fixation, two had external fixators and two patients had debridement during the initial treatment. The average time duration between injury and presentation was 7 months (range, 1-30). All patients underwent debridement and stabilisation with Orthofix fixator. RESULTS The mean follow-up was 26 months (range, 3-72). The fracture healed successfully in all patients. The average time to union was 4 months (range, 2-6). Seven patients had secondary bone grafting. One patient had revision surgery with internal fixation and bone grafting for failure of Orthofix external fixation. All patients had resolution of infection. The complications seen were pin tract infections in four patients and shoulder stiffness in two patients. CONCLUSIONS Infected non-unions of humeral shaft can be successfully treated with debridement and skeletal stabilisation using Orthofix external fixator. Bone grafting augments fracture healing. Resolution of infection can be achieved.