Abstract
Introduction Humeral fractures comprise from 5 % to 8 % of all fractures. Nonunion rate of humeral fractures is 5.5–8.7% with open reduction and internal fixation (ORIF) technique and 3–5.6 % with the use of locked intramedullary nailing technique. Its frequent causes are infection, poor vascularity, severe comminution or technical errors. Purpose Analysis of effectiveness of vascularized bone grafting and non-vascularized bone grafting in humeral nonunion and defect treatment. Material and methods Surgical management of 69 patients with humeral nonunion was performed from 2010 to 2017 at a single institution in two groups. Vascularized bone grafts were used in 41 cases and non-vascularized ones in 28 cases. X-rays and CT-scans of all the patients were studied. Results In the vascularized bone grafting group, union was achieved in 36 cases (88 %) after four to 6 months; in non-vascularized bone group union was achieved in 20 cases (71 %) after eight to 12 months. Conclusion In post-traumatic humeral nonunion and bone defects, after two or more failed surgical procedures performed previously, vascularized bone grafting yields more satisfactory results and reduces the total healing time.
Highlights
Humeral fractures comprise from 5 % to 8 % of all fractures
The aim of the study was to compare the efficacy of vascularized and non-vascularized bone grafting in achieving union in the treatment of humeral pseudoarthrosis and defects
Effectiveness of vascularized and conventional bone grafting in achieving union in humeral pseudarthrosis
Summary
Humeral fractures comprise from 5 % to 8 % of all fractures. Nonunion rate of humeral fractures is 5.5–8.7 % with open reduction and internal fixation (ORIF) technique and 3–5.6 % with the use of locked intramedullary nailing technique. Purpose Analysis of effectiveness of vascularized bone grafting and non-vascularized bone grafting in humeral nonunion and defect treatment. Material and methods Surgical management of 69 patients with humeral nonunion was performed from 2010 to 2017 at a single institution in two groups. Fractures of the humerus account for 5 to 8 % of all skeletal fractures [1–3]. Their nonunion rate after plating ranges from 5.5 to 8.7 % of cases, and 3–5.6 % after locked intramedullary osteosynthesis. The most frequent tactics of re-operation is removal of the previous implant, re-osteosynthesis, most often with a plate and autoplasty of the humerus with a graft from the iliac crest [2]. The success rate for repeated surgical interventions ranges from 70 to 92 % [3, 8, 9]
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