Outcomes of Open Reduction and Internal Fixation for Humeral
A Study was conducted to document union rate, complications and patient-reported outcomes after open reduction and internal fixation (ORIF), with and without bone grafting (BG), for humeral diaphyseal nonunion after failed nonoperative management.

86 consecutive patients underwent nonunion ORIF (plate and screws) at a mean of 7 months postinjury (range 3–21.5). 13% underwent supplementary BG.

Union rate and complications for 83 patients (97%) at a mean of 10 months (3–61). Patient-reported outcomes for 53 living, cognitively-intact patients (78%) at a mean of 4.9 years (0.3–9.2).

Results:
--93% (n = 77/83) achieved union after nonunion ORIF. Complications included recalcitrant nonunion (7%, n = 6/83), iatrogenic radial nerve palsy (6%, n = 5/83), infection (superficial 7%, n = 6/83; deep 2%, n = 2/83), and iliac crest donor site morbidity (38%, n = 3/8).

--The union rate with BG was 78% and without was 95%, and was not associated with the nonunion type (atrophic 91%, n = 53/58; hypertrophic 96%, n = 24/25).

--Median QuickDASH was 22.7, EQ-5D 0.710 (0.181-1), EQ-visual analog scale 80 (10–100), SF-12 physical component summary 41.9 (16–60.5), and mental component summary 52.6 (18.7–67.7).

--19% were dissatisfied with their outcome.

Finally, a high rate of union was linked to ORIF for humeral diaphyseal nonunion. There was no need for routine BG, which reduced the risk of donor site morbidity. Despite the majority of patients attaining union, one out of every five patients was unsatisfied.

Source: https://journals.lww.com/jorthotrauma/Abstract/2021/08000/Open_Reduction_and_Internal_Fixation_for_Humeral.4.aspx
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