Objectives: To determine whether using a fixed-angle locked plate plus a fibular strut autograft to treat humeral surgical neck nonunions can result in improved union. Patients and Methods: The study cohort included 5 females and 2 males with an average age of 58.4 years (range 45–76) who presented with atrophic nonunion of the surgical neck of the humerus. All patients underwent revision surgery with locked plating plus a nonvascularized autologous fibular strut bone graft. Clinical and radiological union was documented in all patients. Results: The mean time from initial trauma to last revision surgery was 20.1 ± 12.6 months (range 12–48). The average time between revision surgery and the date of union was 6.1 months (range 5–8). The average active forward flexion was 124° (range 70–160) at final follow-up. The Constant-Murley score increased from an average of 25.7 points preoperatively to 77.7 points postoperatively (p < 0.001). The average analog scale of pain decreased from 7.57 points (range 6–10) preoperatively to 0.57 points (range 0–2) postoperatively (p < 0.001). Conclusions: Locked plate fixation and autologous fibular strut bone graft facilitated the successful treatment of humeral surgical neck nonunions.

Keywords:
Proximal humeral nonunion, Locked plate, Bone graft
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© 2012 S. Karger AG, Basel
2012
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