Blade plate fixation of proximal humeral non-unions.

Non-union of fracture of the proximal humerus is unusual and can be difficult to treat. It is found more often than not in the elderly patient with weak bone, resorption at the fracture site, contracture of the glenohumeral joint and associated medical conditions. A blade plate, designed specifically for the treatment of these non-unions, was used in nine patients--seven females and two males (mean age 66 years)--who had painful non-union with a mean duration of 22.5 months. Autologous bone grafting was used in all cases. Eight non-unions followed displaced two-part proximal humeral fractures: five had been initially treated conservatively and four with medullary nails. Five patients had associated medical illness. After a mean of 6.5 months (range 4-28 months), union had been achieved in all but one patient. Functional evaluation revealed good results in five patients, fair results in three and one poor result. Use of the blade plate offered a successful method of stable internal fixation in these complex cases.