Two-Plate Fixation for Humeral Shaft Nonunions

Abstract

Purpose.To review 22 patients who underwent 2-plate fixation for non-union of the humeral shaft. Methods. 13 women and 9 men aged 32 to 76 (mean, 48) years underwent fixation for non-union of the humeral shaft, using a 2-plate construct, together with decortication, debridement, and bone grafting. The two 3.5-mm reconstruction plates were parallel and lying at 90º to each other and fixed with screws purchasing into at least 6 cortices of each fragment for both plates. Fractures were located in the upper third (n=8) or middle third (n=14) of the humerus. Initial treatments included casting (n=9), coaptation splinting (n=8), multiple retrograde pinning (n=4), and Marchetti-Vicenzi nailing (n=1). 18 non-unions were atrophic and 4 were hypertrophic. Shoulder and elbow range of motion as well as functional results were evaluated. iatrogenic radial nerve palsy that recovered within 3 months. Conclusion. Two-plate fixation achieves good results for humeral shaft non-unions.

Treatment of Humeral Shaft Aseptic Nonunions in Elderly Patients With Opposite Structural Allograft, BMP-7, and Mesenchymal Stem Cells

“…Despite the good results observed with different surgical techniques, advanced age seems to be a clear risk factor for failure. 2,6,11,12 Volgas et al 3 assessed the impact of several risk factors on the outcome and nonunion rate of humeral fractures. Advanced age, comorbidities, and previous surgeries all contributed to malignant nonunion.…”

“…The literature reports satisfactory results with all of these devices. 2,5,6,[10][11][12][13][14][15] In patients with osteoporotic bone, clinical and biomechanical studies have observed significantly improved stability with the use of a locking plate. 2,16 In light of these findings, the current 2 patients were treated with a Synthes LCP plate, which allows use of either a locking or a compression screw in any hole.…”

Anteromedial Plating of Humerus—An Easier and Effective Approach

“…Plate osteosynthesis remains the gold standard of surgical treatment. Plate fixation results in high union rates but requires extensive dissection and soft tissue stripping [3]- [5]. The most commonly used approaches for treating these fractures are posterior and anterolateral [6]- [10].…”

Humerus kaynamamaları

“…Kırık hattında stabiliteden şüphelenilen olgularda, anteriordan ikinci bir plak uygulanabilir. [7] Ardından, kırık sahasının ya kortikospongiyöz cips greftlerle (Şekil 9) ya da iliak kanattan alınan takoz greft (Şekil 10) ile desteklenmesi Şekil 8. Kırık parçaları arasına kompresyonu sağlamak için lag vidası uygulanmış olgu.…”