From plate to nail: a case-report of proximal humerus non-union.

The rate of non-union is estimated to be 1.1% to 10% following closed treatment of proximal humerus fracture. Treatment options include revision of fixation and biological enhancement using osteoprogenitor cells, growth factors and scaffolds. However, it is essential to plan the correct type of reconstructive strategy based on the evaluation of the non-union type. The use of the Non-Union Scoring System (NUSS) in this respect can aid the clinician to reach the right decision. We report a case of a 40 years old man who developed an aseptic proximal humerus non-union treated initially with ORIF (Philos(®) plate), bone substitute (Orthoss(®)) and bone morphogenetic protein 7 (BMP-7). Due to implant failure, twelve weeks later the fixation was revised to Titanium Cannulated Humeral Nail. Osseous healing was noted 5 months later.