DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20162822

Locking compression plate in humeral shaft nonunion: a retrospective study of 18 cases

Rajesh Govindasamy, Ramkumar Gnanasundaram, Saravanan Kasirajan, Fawas Thonikadavath, Jeff Walter Rajadurai

Abstract


Background: Humeral shaft nonunions are frequently seen in Orthopaedic practice. Osteosynthesis with bone grafting is the treatment of choice. Locking compression plate (LCP) is the latest implant used in treating them. We retrospectively evaluated the outcome of use of LCP in humeral shaft non-union resulted by both conservative management and following failed internal fixations.

Methods: Eighteen patients with nonunion of humeral shaft in which ten were treated by traditional bone setters and eight followed by failed internal fixation were included in these study. The mean duration of nonunion was 18.3 months (range 8-22).  The mean follow up period was 18 months (range 12-26). The mean age of patients was 44.4 years (range 22-60). All patients underwent osteosynthesis with LCP and autologoous cortico-cancellous iliac crest graft. The outcome measures include radiographic assessment of fracture union and preoperative and postoperative function using modified constant and murley scoring system.

Results: All fractures united following osteosyntesis average time for union was15 weeks (range 10-24). We did not have any delayed union or non-union. The complications were superficial infection (n=1) and wound haematoma (n=1).Three patients with preoperative radial nerve palsy recovered at the end of four months. Functional evaluation using constant-murley score showed excellent result in 14, good in 3 and fair in 1. We did not have any poor results.

Conclusions: LCP with cancellous bone grafting is a safe reliable option for all forms of humeral shaft nonunion. We recommend it.

Keywords


Humeral fractures, Nonunion, Internal fixation, Osteosynthesis, Plates

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