Original Research
Atrophic Nonunion of Humeral Diaphysis Treated With Locking Plate and Recombinant Bone Morphogenetic Protein: Nine Cases
Am J Orthop. 2009 November;38(11):567-570
Author and Disclosure Information
Charles H. Crawford III, MD, and David Seligson, MD
Dr. Crawford is Assistant Professor, and Dr. Seligson is Professor, Vice Chair, and Chief of Fracture Service, Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky. Dr. Crawford was an orthopedic resident at the time the article was written.
Nonunions of the humerus are debilitating for patients and challenging for surgeons. We retrospectively reviewed our first 9 humeral nonunions treated with a locking plate and commercially available recombinant bone morphogenetic protein. At latest follow-up, 8 patients showed clinical and radiographic signs of union. One patient had a persistent (11-year) nonunion that failed to unite at 1 year, despite new bone formation, and underwent revision with the same technique. The reported technique is a useful part of the surgeon’s armamentarium in treating difficult humeral nonunions. We found a high union rate with an acceptably low complication rate in this difficult population.