[Treatment results of pseudarthrosis of the humeral shaft by open reduction and internal fixation with dynamic compression plating].

OBJECTIVES

We evaluated the results of open reduction and internal fixation with the use of dynamic compression plating in patients with pseudarthrosis of the humeral shaft.

METHODS

Eighteen patients (12 males, 6 females; mean age 41 years; range 22 to 68 years) with aseptic pseudarthrosis of the humeral shaft were treated by open reduction and internal fixation with the use of a dynamic compression plate following unsuccessful treatment with conservative (n=7) or surgical (n=11) methods. The mean interval between the initial and final treatments was 12.2 months (range 5 t 46 months). Exploration of the radial nerve and autogenous corticocancellous grafting were simultaneously performed in all the cases. Functional results were evaluated according to the Stewart-Hundley's criteria. The mean follow-up was 38.8 months (range 12 to 78 months).

RESULTS

Union was achieved in all (94.4%) but one patient within a mean duration of 5.5 months (range 3 to 8 months). Functional results were good in fourteen patients (77.8%), fair in three patients (16.7%), and poor in one patient (5.6%). Radial nerve palsy that occurred in two patients during the early postoperative period underwent spontaneous recovery within three and five months, respectively. Mild reflex sympathetic dystrophy developed in two patients.

CONCLUSION

In selected patients with pseudarthrosis of the humeral shaft, the results of open reduction and internal fixation with the use of dynamic compression plating are excellent, provided that an appropriate surgical technique is employed.