Operative management of humeral nonunions. Factors that influence the outcome

Abstract

Aim: The purpose of this study is to present the outcome of surgically treated humeral nonunions and find factors that affect the outcome.Patients and Methods: 45 patients with humeral nonunions (33 shaft, 7 proximal and 5 distal) were reviewed in a prospective manner. Treatment was based on a specific algorithm. Demographics, time to union, range of motion, functional outcome and complications were recorded and analysed.Results: Mean follow-up was 79.3 months and mean time to union was 4.3 months. Infection was associated with delayed union of the pseudarthrosis, while range of motion was negatively affected by the location (proximal) and the AO type of the initial fracture. Complication rate was 16%.Conclusion: The surgical management of humeral nonunions yields a favourable outcome with reduced rate of complications. Infection prolonged healing time, while proximal location of the nonunion and the type B or C fracture according to AO/OTA classification adversely affected range of motion