"Nonunion of Adult Humerus Fracture" - Management Using the Ilizarov External Fixator.

Abstract

:Humeral shaft fractures occur about three percent of all fractures in adults. A very high union rate is achieved with non-operative treatment, however when nonunion occurs conservative approach or after operative management they are often very difficult to treat, and often requires multiple procedures to achieve union. Even with multiple procedures, true pseudoarthrosis have only a 59% union rate. The aim of this study was to find out the results of such complicated cases treating with Ilizarov's external fixator. We conducted a prospective study of eleven patients with nonunion humeral shaft fracture in adult wherein the outcome of the treatment was analyzed. In our series we achieved union in all of the cases with a mean of 29.1 weeks with negligible complications like pin tract infections and in one case refracture occur due to forceful manipulation. So it can be concluded that Ilizarov's method is an excellent option for the treatment of nonunion of diaphyseal fracture of the humerus.

The effect of single plate and double plate application on union and functional results in humeral diaphyseal nonunions

“…Union rates from 40% up to 100% have been achieved in treatments with intramedullary nailing (15)(16)(17), with union times ranging between 4.2 to 6 months (15,17,18). Successful results of up to 100% and union times ranging from 5.5-7.2 months have been reported with treatment using the Ilizarov external fixator (13,(19)(20)(21). When using plates to treat nonunion, single-plate and doubleplate methods are performed.…”

Outcome of fixation for humeral mid-shaft fractures in adults by elastic nails on 40 patients postoperatively

“…This finding is similar to the results of many studies that explored the main causes of union failure after surgical treatment of humeral fractures and revealed that carrying weight and appropriate axial rotation movements are essential in bone healing of humerus [15][16][17] . Mid-shaft humeral fractures had high rates of non-union 29 that needs adjuvant physiotherapeutic techniques added to optimum surgical intervention to acquire better outcomes 30 . Absence of complete bone reduction, absence of stable and rigid fixation in addition to high muscular load on humerus was the main reasons for late healing 17.…”