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Abstract
A low incidence of humeral nonunions has been reported with predisposing factors listed as inadequate immobilization, open reduction and internal fixation, infection, distraction, trans verse fractures, and significant soft tissue injury. When nonunion occurs, the humerus is often osteoporotic, with rigid fixation difficult to achieve and prone to failure Many methods of treatment have been employed for this difficult problem.
Authors have experienced 9 cases of nonunion of humeral shaft fracture and accomplished solid union in all cases by osteosynthesis accompanied by autogenous bone graft.
The results were as follows
1. Of the 9 cases, male were 7, female were 2. Prevalent site was found mostly at the middle 1/3.
2. Initial treatment were surgical in 7 out of 9 cases, and on retrospective analysis of medical records and X-ray films, probable cause of the nonunion were supposed to be too early performed inadequat internal fixation.
3. The treatment performed were somewhat variable to included open reduction and rigid plate fixation for 8 cases, and open reduction and intramedullary nailing for 1 case. All were supplemented with autogenous iliac bone graft.
4. Union was obtained in all cases. All were united at average 4.9 months.
5. Postoperative immobilifation was done for average 8.7 weeks. Limitation of motion of shoulder and elbow in 3 cases, which required considerable time of physical therapy.
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