Results of using intramedullary autogenous fibular strut graft as an adjunct to dynamic plating in atrophic non-union of humeral mid-shaft fracture

Abstract

Introduction: Atrophic nonunion of the humerus is rare and complex condition to treat. Several surgical techniques have been used for the treatment of non-union, which include compression plating, intramedullary nailing and use of external fixators, with or without bone grafts. Use of autogenous fibular as a strut graft is proposed to achieve good union and functional recovery. The aim of this study was to assess the clinical result of the intramedullary fibular graft adjunct to dynamic plate fixation in diaphyseal atrophic non-union of the humerus.Methods: The present prospective study was carried out within the period of January 2019 to December 2021 in the Department of Orthopedic Surgery of Bangabandhu Sheikh Mujib Medical University. Fifteen patient (09 male and 06 female) with atrophic non-union of the humerus midshaft fracture within the age range of 41-60 years were selected. All the case had non-union of the fracture of the middle third of humerus with a delay in commencement of specific treatment. The clinical and radiological outcome of Surgery has been assessed using definite recommendation. Statistical results were obtained by using the SPSS program.Result: The mean union time was 5.65 months. Post-operative complications were noticed in 3 patients, infection in 01 patient and 02 patients had persistent pain due to failure of union. Regarding the final outcome, satisfactory results were found in 86.66% case and unsatisfactory result in 13.33% case.Conclusion: The intramedullary fibular auto graft with dynamic plating results in satisfactory clinical outcome in atrophic osteoporotic diaphyseal non-unions of the humerus.