Non-unions after humeral shaft fractures are frequently encountered – about 2-10% after conservative management and 30% after surgical treatment.

The purpose of a new study published in the Journal of Clinical Orthopaedics and Trauma evaluated the outcomes of an on-lay bone graft strut construction with bone chips as grafting augmentation in the management of aseptic non-unions of the humeral shaft.

In this study, 48 patients with a humeral shaft non-union were selected. An anterolateral humeral approach was used in all cases, with an on-lay bone graft using an allograft strut construction and with bone substitute augmentation in the non-union gap.

It was observed that all 48 patients achieved full bone healing without major complications. The average period of union was 124 days. In 40 cases, the alignment was neutral after healing; whereas, valgus deformation occurred in 6 cases and varus deformation in 2 cases. Moreover, at twelve months after surgery, all patients recovered with satisfactory ranges of motion of shoulder and elbow and a good quality of life, without any radial nerve palsies or other major complications.

It was inferred that plating with supporting allograft is a good choice of treatment in cases of aseptic non-union of the humeral shaft.

Source: Journal of Clinical Orthopaedics and Trauma. 2020 Feb;11(Suppl 1):S51-S55. doi: 10.1016/j.jcot.2019.08.020. Epub 2019 Aug 31.