Causes and treatment of humerus bone nonunion

Abstract

Objective To explore the causes of humerus bone nonunion and the c linic effects of different fixators and bone grafts in treatment of humerus bone nonunion. Methods 51 cases of humerus bone nonunion, 36 males and 15 females, w ere analyzed retrospectively. Different fixations were applied for the patients: plates in 30 cases, interlocking medullary nails in 12 cases, external fixators in 8 cases and allograft-bone plate with screws in 1 case. For bone graft, Rec onstructed Bone Xenograft (RBX) was used in 12 cases, autogenous ilium in 16 cas es, autogenous ilium plus RBX in 17 cases, allograft-bone in 2 cases and allogr aft-bone plus RBX in 2 cases. Results Of the 51 cases, 2 were out of follow-up , 49 cases were followed up for 8 months to 9 years, with 4 years and 7 months o n average. The total union-rate was 89.8%. The union-rate in patients with pl ate fixation was 83.3%, with external fixator 100%, and with interlocking medu llary nails 100%. The union-rate in patients with RBX was 100%, with autogeno us ilium 87.5%, and with autogenous plus RBX 88.2%. Conclusions The treatment of humerus bone nonunion with interlocking medullary nails or external fixators is superior to that with plates in that it is less invasive, and provides effect ive fixation and satisfactory functional recovery as well. Since RBX has good bi ocompatibility and does not result in immunological rejections, it can be safely used in the treatment of bone nonunion and has reliable effects on promoting bo ne healing.