Abstract
BackgroundNonunion following fracture of the proximal humerus is not uncommon, particularly in the elderly. Stable internal fixation is essential to obtain healing of a nonunited fracture of the proximal humerus.AimThis study aimed at evaluation of the results of open reduction and internal fixation of nonunited fractures of the proximal humerus using the locked plate, synthetic and autogenous bone graft.Patients and methodsTwelve patients diagnosed with nonunited fracture of the proximal third of the humerus were included in this study conducted between 2009 and 2011 in Suez Canal University. Eight patients were female and four were male. The mean age of the patients was 72.3 years (range, 65-80 years). The time between injury and surgery ranged from 6 to 12 months (mean 8.7 months). Three patients had undergone previous operations for persistent nonunion. The follow-up period lasted for 7-12 months, with a mean of 9.3 months. Radiographic evaluation was carried out with biplane radiographs taken at the time of the most recent follow-up evaluation, to determine the presence of bridging osseous trabeculae, which is suggestive of healing, as well as any loosening or failure of the fixation. The objective results were assessed on the basis of the modified scoring system of Constant and Murley. The subjective results were assessed on the basis of the score derived from the Disabilities of the Arm, Shoulder, and Hand Questionnaire.ResultsRadiological bone healing was documented in 11 of 12 patients. Objective and subjective assessments documented marked functional improvement in patients with healing fractures. The results were classified as good in 11 of 12 patients, and few complications were encountered.ConclusionLocked plate used in conjunction with synthetic and autogenous bone grafting is an excellent device for the treatment of proximal humerus nonunions with minimal complications.
Published Version
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