The treatment of nonunions and pseudarthroses of the humeral shaft.

Abstract

In summary, if one follows the AO/ASIF principles of open reduction and stable internal fixation of nonunions and pseudarthroses of the humerus, mostly with plate fixation supplemented by shingling or petaling, cement for loose screws when necessary, and bone grafting of defects or atrophic nonunions, then successful healing with one operative procedure can be achieved in over 95%, with almost full correction of preoperative deformity. Return of useful function and range of motion can also be achieved in 75% to 90% by early active exercises, physiotherapy, and occasional continuous passive motion, supported by hinged braces or cast braces in the postoperative period until union occurs. Union was achieved in an average of 6.6 months after the operative procedure.