The Journal of Bone and Joint Surgery, Vol 67, Issue 6 857-864, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Internal fixation of fractures and non-unions of the humeral shaft. Indications and results in a multi-center study
RJ Foster, GL Dixon, AW Bach, RW Appleyard and TM Green
We performed ninety-six internal-fixation procedures for fracture or
non-union of the humeral shaft in eighty-four patients, with a mean
follow-up of 32.6 months (range, three months to fourteen years). The
primary indications for operative intervention included humeral shaft
fracture in a patient with multiple trauma, non-union, inadequate reduction
of a humeral shaft fracture by closed methods, pathological humeral-shaft
fracture, and progressive radial-nerve palsy. Methods of internal fixation
included compression plates and screws and intramedullary Kuntscher nails
or Rush rods. The use of an AO/ASIF compression plate or interfragmentary
lag screws with an AO/ASIF neutralization plate in twenty-seven
multiply-injured patients resulted in a union rate of 100 per cent and
generally good motion of the shoulder and elbow. Five multiply-injured
patients also obtained good results through fixation by a modified
Hackethal technique using two Rush rods. The use of intramedullary
Kuntscher nails resulted in a rate of union of 91 per cent in eleven
multiply injured patients. Ten patients with non-union of a humeral shaft
fracture had an 80 per cent rate of union with the use of an AO/ASIF
compression plate. The use of a Kuntscher nail in eleven patients with
non-union resulted in a rate of union of only 73 per cent and frequently
caused subacromial impingement. Fractures of the humeral shaft that had had
an inadequate reduction by closed means or were associated with progressive
radial-nerve palsy were best managed by a compression plate or the modified
Hackethal technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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