Treatment of bone loss defects and pseudoarthroses of the humerus with vascularised autografts

Abstract

Results of treatment of 31 patients with non-union of the humerus are presented. There are 25 defects of the humerus and 6 pseudoarthroses of various genesis and different localisation. Shortening of the humerus ranged from 3 to 15 cm. Routine free vascularised bone or composite skin/bone autografting was done for all patients. In 28 cases vascularised fibular pedicle graft was used, in 4 of which the fibular head to reconstruct the shoulder joint was used. An iliac crest graft was used in remaining 3. In 9 patients with shortening of the humerus over 5 cm distractionusing Ilizarov device was followed by bonee grafting. In 27 patients Ilizarov device was epplied for osteosynthesis after bone grafting. Long term outcome was studied in 27 of the 31 cases and the results were uniformly satisfactory.