Abstract
Proximal humeral non-unions are uncommon, but when they occur they are disabling and often present a surgical challenge.
We have treated 55 cases of proximal humeral fractures by internal fixation from March 2002 to March 2004. Of these, 18 were non-unions out of which 16 were treated using AO Cannulated blade plate and bone grafting. Results of these patients are presented in this report.
14 out of 16 were available for follow up, which ranged from 18–30 months. Patients were regularly reviewed clinically and radiologically and had constant and DASH scoring at final follow up. Average Constant score was 64 and DASH score was 35.3. Range of movement recovered to 50% or more in every patient but only 3 had full range of movements. Maximum recovery in the strength of shoulder muscles measured with myometer was about 75% as compared to other side. Although X-rays showed sound bony healing in all but one case, none of the patients was completely symptom free at final review. However, they were all satisfied with the outcome of their operation.
Stable internal fixation is the key to success of surgical treatment of non-unions. We are satisfied with the usefulness of AO cannulated blade plate in providing a rigid fixation in our cases. However, it is difficult to achieve perfect results in terms of pain relief and recovery of normal function due to various reasons, which would be highlighted in our presentation. The report would also discuss the technical difficulties encountered in using this implant.
Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.
