ACTA FAC. MED. NAISS. 2006; 23 (3): 139-143

   Original article

Ivan Micic¹, Desimir Mladenovic¹, Zoran Golubovic¹, Nina Abbasher¹ , Sasa Karalejic¹, Predrag Stojiljkovic¹, Jeon IH²

¹Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Nis, Serbia
²Department of Orthopaedic Surgery, Kyngpook National University Daegu, Korea

    SUMMARY

The incidence of nonunion after humeral shaft fractures is reported as low because of the favorable results of conservative treatment. The treatment of humeral shaft nonunion is challenging, often requiring one or more surgical interventions. Different surgical methods were described for humeral shaft nonunion with complication such as radial nerve palsy or joint stiffness.

Retrospectively, we reviewed 33 patients with aseptic humeral shaft nonunion treated by different methods. Patients were followed for a mean of 42.9 months (range, 36 to 66 months). The inclusion criteria was aseptic shaft nonunion without bone defects more than two centimeters. Six patients had hypertrophic and twenty-seven patients had atrophic nonunion.

Solid union, as documented on plain radiographic views, was obtained in thirty-three (100%) patients. Overall, the average healing time was 4.5 months (range, three to nine months). According to Constant and Murlay score, 23 (69.7%) patients had excellent outcome and 10 (30.3%) patients had good outcome. Excellent results were achieved using Mitkovic selfdynamisable internal fixator in four patients, Mitkovic external fixator in seven, plate in eleven, and intramedullary nail in one patient.

In this retrospective study, the selfdynamisable internal fixator and unilateral external fixator - both with less invasive surgical technique tended to yield equally favorable treatment results as did plate and intramedullary nail fixation. In our series, all used methods led to a high percentage of nonunion healing with good functional results and minimal complications.

    Key words: humeral shaft, nonunion, Mitkovic selfdynamisable internal fixator, Mitkovic unilateral external fixator, plate, intramedullary nail, bone graft