Revision surgery for nonunion after early failure of fixation of fractures of the distal humerus

Author:

Ali A.1,Douglas H.1,Stanley D.1

Affiliation:

1. The Shoulder and Elbow Unit, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.

Abstract

Sixteen patients who underwent a revision operation for nonunion of fractures of the distal humerus following previous internal fixation were reviewed at a mean follow-up of 39 months (8 to 69). The Mayo elbow performance score was excellent in 11, good in two, fair in two and poor in one. In 15 patients union was achieved and in one with an infected nonunion a subsequent bone graft was necessary in order to obtain union. Age, gender, a history of smoking, mechanism of the injury and the AO classification of the initial fracture did not correlate with the development of nonunion. In 12 patients (75%), the initial fixation was assessed as being suboptimal. The primary surgery was regarded as adequate in only three patients. Our findings suggest that the most important determinant of nonunion of a distal humeral fracture after surgery is the adequacy of fixation.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

Reference16 articles.

1. Sim FH, Morrey BF. Non-union and delayed union of distal humeral fractures. In: Morrey BF, ed. The elbow and its disorders. Second ed. Philadelphia: W.B. Saunders Co. 1993:367–82.

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