Long-term follow-up of persistent humeral shaft non-unions treated with tricortical bone grafting and compression plating.

Three percent of all fractures occur in the humeral shaft. A very high union rate is achieved with nonoperative treatment. When non-unions occur, however, they are often very difficult to treat, and often require multiple procedures to achieve union. Even with multiple procedures, true pseudoarthroses have only a 59% union rate10. We conducted a retrospective study of ten patients having persistent non-union of the humeral shaft, three of whom had a true pseudoarthrosis. An patients were treated with a compression plate and a tricortical iliac crest bone graft anchored rigidly across the fracture site with two screws applied at 90 degrees to the plate. A solid union was achieved in all ten (100%) patients.