Nonunion of the Surgical Neck of the Humerus: Treatment With Fibular Graft and Locking Plate Fixation

Ahrens, Philip; Nicoletti, Simone; Houghton-Clemmey, Robert

doi:10.1097/bte.0b013e3181cc9a3f

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…The mean age of the patients in our study is 54.3 years ( Table 3 ). This is comparable to the Ahrens et al study (56.2 years), which treated five such non-union using autologous FSG and locking plate and achieved a satisfactory outcome in 80% of the cases [ 21 ]. Our study has a female-predominant population (M:F=2:4) like most of the studies, e.g.…”

Section: Discussionsupporting

confidence: 85%

“…Our study has a female-predominant population (M:F=2:4) like most of the studies, e.g. : Badman et al (0:18), Hettrich et al (0:3), Ahrens et al (1:4), Allende and Allende (0:7), Gao et al (2:5), Quadlbauer et al (3:6) [ 16 , 17 , 21 - 24 ].…”

Section: Discussionmentioning

confidence: 77%

“…PHN is associated with considerable morbidity including pain and stiffness, in association with shoulder dysfunction in most [ 21 ]. There are no guidelines available to manage very late presenting PHN.…”

Section: Discussionmentioning

confidence: 99%

“…There was discomfort, occasional pain, and restriction of overhead abduction due to hardware prominence in one patient. One of the five patients in the Ahrens et al study had developed donor site morbidity, in his study (sensory changes in the area of superficial peroneal nerve improved in 6 weeks) and failure of fixation in 15 months [ 21 ]. In our study, we have noticed no donor site morbidity in any case.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of Osteosynthesis of Late-Presenting Proximal Humerus Non-union: A Case Series

Mukhopadhaya,

Singh,

Gupta

et al. 2024

jocr

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Introduction: It can be challenging to treat proximal humeral non-union (PHN). The challenge gets compounded when they are presented either late or after previous surgery. The challenges are far greater due to small proximal fragments, scalloping of the head, medial bone defect, osteoporosis, soft tissue contractures, and problems related to the previous implants. Materials and Methods:In this retro-prospective study (2007–2020), we report on six cases of PHN which were presented to us more than 5 years after the original injury and managed using an intra-medullary autologous fibular strut graft (FSG) along with fixation with a proximal humeral locking plate and cancellous bone grafting. We quantified shoulder function based on constant score and disabilities of the arm, shoulder and hand (DASH) score. Results: The mean age of patients is found to be 54.3 years (range, 22–74 years) with females dominating our study. The mean pre-operative constant score is 26.33 which improved to 71.83 in the post-operative period. The mean DASH score is 77.98 preoperatively, which improved to 19.5 postoperatively. The paired sample t-test compared the difference in mean of the pre-operative and post-operative scores, which shows significant improvement in outcome. Conclusion: Even in very late PHN in poor-quality bone, the additional use of intramedullary strut grafts provides structural support to the fixation and further enhances the ability to withstand the load-start early motion and have a satisfactory functional outcome. Keywords: Non-union, proximal humerus non-union, proximal humerus fracture, proximal humerus internal locking system, locking plate, autogenous fibular strut graft.

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Section: Discussionsupporting

confidence: 85%