Infected gap nonunion of fractures proximal humerus in adolescent: an outcome of 12 cases

Sanjay Kumar Rai, Rohit Vikas, Naveen Shijale


Background: There is little data about the risk factors, demographics, and prognosis for nonunions in children. Previous literature has reviewed time periods when contemporary techniques of internal fixation and management of open injuries had not been available. Infected gap nonunion of proximal 1/3 humerus in adolescent is not much reported the in literature. The purpose of our study was to evaluate the outcome of infected gap nonunion in 12 cases of adolescent treated by debridement and fibular graft and plating.

Methods: This study was conducted between 2009 to 2015, 12 cases of Infected gap nonunion of fractures proximal humerus was included in our study. Each child was followed up minimum for 12 months.  Although non unions in the pediatric population are rare, these data underscore the importance of careful evaluation and treatment of these fractures at risk for nonunion.

Results: In our series of 12 cases of infected nonunion of fracture humerus which were treated by bone grafting using fibula strut graft and plating resulted 99% union rate. The rate of union is depending on thorough debridement and fixation along with bone grafting.

Conclusions: Nonunion of pediatric fractures is a rare complication. Most studies on developing pediatric nonunions describe specific fractures that are particularly susceptible to nonunion and malunion, nonunion of humeral lateral condyle and open tibia fractures have received the most attention. Reports of nonunion among pediatric long bone fractures are rare, being either case reports or isolated entities in a larger series of predominantly adult fractures. Fibula is a popular substitute for this method because of its easy accessibility and minimal donor site morbidity.


Humerus shaft fracture infection, Gap nonunion, Fracture proximal 1/3 of humerus, Adolescent, Osteomyelitis humerus

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