Salvage of humeral nonunions with onlay bone plate allograft augmentation

Francis J. Hornicek, Gregory A. Zych, James J. Hutson, Theodore I. Malinin

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Eight women and one man were treated for 10 established diaphyseal humeral nonunions. Six patients sustained fractures in motor vehicle accidents and two patients sustained fractures in a fall. Two of the fractures were open. One patient with multiple myeloma originally was treated conservatively and received local radiation, followed by open reduction and internal plate fixation. The other patients previously were treated with fracture braces, intramedullary nails, dynamic compression plates, or a combination of these techniques. After removal of the surgical hardware and fibrous tissue at the nonunion site, stable fixation was accomplished using a cortical long bone plate allograft (femoral and tibial) or fibular shaft allograft and a dynamic compression plate. All humeral nonunions had united at an average of 2.9 months. Radiographic incorporation of the allograft cortical bone plate and fibular shaft into the host cortex occurred in all but one patient by 3 months. Graft to host junction healing was accomplished by incorporation of the cortical allograft plate into the host cortex, resulting in an increased diameter of the bone. Cortical allograft bone plates and fibular grafts provide structural and probably osteoinductive support to enhance healing of these nonunions.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalClinical orthopaedics and related research
Issue number386
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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