PSEUDARTHROSIS OF THE HUMERAL NECK: ANALYSIS OF THE RESULTS WHEN USING THE TECHNIQUE DESCRIBED BY WALCH ET AL

ABSTRACTObjective: To evaluate bone healing and the patient's outcome after open reduction and internal fixation, when using the technique described by Walch et al, in 1996, which uses conventional intramedullary corticocancellous bone graft and internal fixation with plate and screws added by a tricortical intramedullary bone graft, also autologous. Methods: From July 1997 to May 2005, 14 patients were treated by this technique, 14 of these diagnosed with pseudoarthrosis of the humeral proximal end. One died at the early postoperative period due to pulmonary thromboembolism; therefore, 13 patients were re-evaluated. Results: The mean follow-up time was 51.4 months (ranging from 12 to 130 months). Four patients evolved with excellent results, four good and five fair results. Therefore, there were 61.5% of satisfactory results according to UCLA functional scale and no poor result. Twelve cases (92%) healed within 3.5 months in average. Conclusion: the surgical treatment of the nonunion of the surgical neck of the humerus using this technique showed an effective outcome with 92% of healing; excellent and good results in 61.5% of the cases, as well as satisfaction of all patients with their final results; nonunion resulting from two-part fractures had better results when compared with three-part fractures.