Surgical Treatment of Nonunions of the Surgical Neck of the Humerus in Elderly Patients

Abstract

Purpose : The purpose of this study was to evaluate the results of surgical treatment of nonunion of the surgical neck of the humerus in elderly patients. Materials and Methods : Seven patients over 60 years of age surgically treated for nonunion of the surgical neck of the humerus with follow-up over 1 year were investigated. Of the three patients with severe osteoporosis, multiple K-wires were used in 1 patient, and Ender nails were used in 2. The other 4 patients with relatively good bone quality were treated with plate and screws. Functional results were evaluated using the University of California, Los Angeles (UCLA) shoulder rating scale and statistical significance was tested using the Wilcoxon signed rank test. Results : Radiological union was obtained in six patients, and 1 patient had no evidence of union at a postoperative 5 years. Active elevation improved from an average of 73 (range, 20-100) degrees to 139 (range, 110-160) degrees. The UCLA score improved from 10.9 (range, 7-16) points to 27.3 (range, 10-33) points on the average. Conclusion : Open reduction with internal fixation and bone grafting for nonunion of the surgical neck of the humerus in elderly patients may result in significant functional improvement.