Locking Compression Plates for Osteoporotic Nonunions of the Diaphyseal Humerus
- 1 August 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 425 (425), 50-54
- https://doi.org/10.1097/01.blo.0000131484.27501.4b
Abstract
Poor bone quality increases the technical difficulty and complications of operative treatment of nonunions and delayed unions of the diaphyseal humerus in older patients. Plates with screws that lock to the plate (transforming each screw into a fixed blade) are intended to improve the fixation of poor quality bone. Twenty-four patients (20 women, four men) with an average age of 72 years (range, 52–86 years) were followed up for a minimum of 12 months after locking compression plate fixation of an osteopenic delayed union (nine patients) or nonunion (15 patients) of the diaphyseal humerus. Twelve patients had iliac crest cancellous bone grafts, two patients had local graft, and 13 patients had demineralized bone applied to the fracture site. All the fractures eventually healed; two healed after a second procedure for autogenous bone grafting in patients who initially received demineralized bone. Using a modification of the Constant and Murley shoulder score, the results were good or excellent in 22 patients, and fair in two patients. Locking compression plates provide stable fixation of poor quality bone in patients with delayed union or nonunion of the humerus. Successful union and restoration of function are achieved in most patients. We no longer consider osteoporosis a contraindication to operative fixation of an ununited fracture of the humeral diaphysis.Keywords
This publication has 22 references indexed in Scilit:
- Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cementEuropean Journal of Surgical Oncology, 1996
- Management of Humeral Nonunion After the Failure of Locking Intramedullary NailsJournal of Orthopaedic Trauma, 1996
- Augmentation of femoral neck fracture fixation with an injectable calcium‐phosphate bone mineral cementJournal of Orthopaedic Research, 1996
- Nonunions of the surgical neck of the humerus: Surgical treatment with an intramedullary bone peg, internal fixation, and cancellous bone graftingJournal of Shoulder and Elbow Surgery, 1996
- The Use of Endosteal Substitution in the Treatment of Recalcitrant Nonunions of the Femur: Report of Seven CasesJournal of Orthopaedic Trauma, 1996
- Blade plate fixation of proximal humeral non-unionsInjury, 1994
- Semitubular Blade Plate for Fixation in the Proximal HumerusJournal of Orthopaedic Trauma, 1988
- A Clinical Method of Functional Assessment of the ShoulderClinical Orthopaedics and Related Research, 1987
- Nonunion of the HumerusClinical Orthopaedics and Related Research, 1986
- The use of bone cement as an adjunct to internal fixation of supracondylar fractures of osteoporotic femursActa Orthopaedica, 1977