抄録
Nonunion of the surgical neck of the humerus which is underlain by osteoporosis in many cases, often challenges treatment. In this report, we evaluated the results of treatment by the operative procedures.
We studied 7 shoulders of 7 patients who were treated by the operative procedures for nonunions of the surgical neck of the humerus in the 9-year-period of from 1985 to 1994. They included 3 males and 4 females aged from 34 to 76 years(average60). The mean initial treatment-to-surgery interval was 9months(range 2 months to 1 year and 10 months). Autogenous bone grafting was carried out on all the patients, using a 95 angle plate in 2 patients and K-wires with tension band wiring in 5 patients.
Good union was obtained in all the patients, the mean period to union being 5 months(range 4 to months). None of them experienced any pain in their day to day activities, and they all returned to their pre-injury occupations or their full range of normal activity. But it took them 6 months to 1 year and 10 months(average 11 months)to restore their maximum range of montion. The patients were left with some restriction of motion, compared with the intact side.
If such on immobilization can be accomplished that a firm fixation, especially in rotation, is achieved, the prognosis would be rather favorable. Therefore, operative procedures should first be considered when a nonunion of the surgical neck of the humerus is encountered instead of hemiarthroplasy.
