Treatment of humeral shaft nonunions: nailing versus plating.

ABSTRACT

INTRODUCTION: The aim of this study was to compare plating and nailing for treating nonunions of the upper two-thirds of the humerus. MATERIALS AND METHODS: Fifty nonunions of the upper two-thirds of the humerus were treated by two different methods: 24 of them by unreamed locked nailing and bone graft (group A), and the other 26 by plate fixation and bone grafting (group B). RESULTS: All fractures healed in both groups. In group A, the time required for healing was 4.2 months (range 4-6 months), whereas in group B it was 4.7 months (range 4-6 months). This difference was statistically significant ( p<0.05). Functional results and the range of motion of the shoulder and elbow were similar with both techniques. In group B there were 3 cases of transient, iatrogenic, radial nerve palsy. CONCLUSIONS: We feel that both plate fixation and the unreamed humeral locked nail are good alternatives for the treatment of humeral shaft nonunions, although nailing achieves union earlier and has fewer complications.