Nonunion of the humerus. Clinical, roentgenographic, scintigraphic, and response characteristics to treatment with constant direct current stimulation of osteogenesis.

Forty-six trauma patients who had developed non-union of the humerus were evaluated from 1972 through 1981 as part of a large prospective study on nonunion. The average age of the 46 patients was 55 years. Women outnumbered men (29 women and 17 men). Seventy-one percent of the fractures occurred below the midpoint of the humerus. Inadequate immobilization and/or distraction and failure of internal fixation devices to obtain and maintain fracture fragment contiguity and stability was noted. Of the 46 patients referred, 39 were treated with constant direct current, using percutaneously inserted electrodes. Senile and disuse osteoporosis (62%), synovial pseudarthrosis (42%), obesity (20%), and osteomyelitis (5%) in this older patient population made this a difficult treatment problem. Seventeen patients' nonunions healed (46%). Electrical stimulation of nonunion of the humerus is not a panacea. Patient selection is critical.