Surgery tactic in humeral nonunion

Abstract

Relevance. Humerus fractures comprise 5 to 8% of all. Nonunions are uncommon, although in cases of infection, poorly vascularized beds, and open, segmental, or severely comminuted fractures, secondary bony healing may still be compromised. In cases of decreased blood supply, the choice of a vascularised bone graft seems inevitable. Purpose of study: analysis of effectiveness and choosing indications for Vascularized bone grafts in humeral nonunion treatment. Patients and methods. 41 humeral nonunion surgery performed from 2010 to 2017 at a single institution: Vascularized fibular grafts were done in 38 and vascularized femoral condylar grafts used in 3 cases. ORIF performed in all cases. X-ray and CT-scan used for control in all patients. Results. After vascularized bone grafting union achieved in 36 cases (88%) in 4 to 6 month, with vascularized fibular grafts in 33 cases and with vascularized femoral condylar grafts in 3 cases. Conclusion. Any humeral nonunion case require individual treatment tactics. Using of vascularized bone grafts can be crucial in lack of local healing process and persistent nonunions of the humerus. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding