Abstract
Humeral pseudarthrosis are common with a non-union rate after fracture between 8% and 13%. Several operative methods have been described for the treatment of humeral pseudarthrosis. The aim of this study was to assess a new approach based on compression using a monoplane external fixator without graft. This study was conducted in the Department of Orthopedic Surgery, and Traumatology of Habib Bourguiba University Hospital in Sfax-Tunisia between April 2009 and September 2018. Fifty-eight patients were operated on using a dynamic monoplane axial fixation device with continuous compression by manipulating the compression system of the fixator. All the cases were evaluated according to the modified Stewart and Hundley classification. The fracture was located in the middle third in 53.4% of the cases. The pseudarthrosis was hypertrophic in 34.5% of the cases. Fifty-four patients were treated with this method as a first cure of non-union and four patients had previously a first cure for their pseudarthrosis. We noted 11 septic pseudarthrosis. The average follow-up was 47.2 months. We obtained consolidation in 98% of the cases. The average consolidation time was 5.1 months. Based on the modified Stewart and Hundley criteria, 75.8% had very good results. This study highlights that a continuous external compression is effective in the treatment of non-unions, as it allows consolidation without opening the pseudarthrosis site and without bone grafting while having satisfactory anatomical and functional results.
Highlights
Humeral shaft fractures represent 1% of skeletal fractures, with a high rate of bone healing
The objective of this paper was to assess the evolution of patients with humeral pseudarthrosis who underwent external continuous compression without bone grafting
Fifty-four patients were treated with continuous external compression as a first cure of non-union and four patients had previously a first cure for their pseudarthrosis and were treated with this method after the failure of the first cure
Summary
Humeral shaft fractures represent 1% of skeletal fractures, with a high rate of bone healing. Unfavorable evolutions are not exceptional, and humeral pseudarthrosis ranges from 8% to 13% [1, 2]. Several operative methods were described in the literature for treatment of humeral shaft pseudarthrosis. The dynamic external fixation with bone graft is classically used [3]. The objective of this paper was to assess the evolution of patients with humeral pseudarthrosis who underwent external continuous compression without bone grafting
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