Management for locking compression plate/dynamic compression plate implant failure in non union osteoporotic humerus shaft bone fracture

IntroductionTo introduce the experience of treating nonunion osteoporotic of humeral fractures with interlocking nailing for failed surgical treatment by plating. Etiology for non-union after failed surgical management of humeral shaft fractures is multi-factorial. Following factors may play a role in nonunion – inadequate fracture fixation with poor contact between the fracture segments, osteomalacia, osteoporosis, infection, devitalization of bone and many more.Materials and methodsA retrospective comparative study of twenty four patients who had locking compression plate failure in osteoporotic humerus shaft fractures treated with interlocking nail and iliac crest bone graft at Gandhi Hospital from 2007 to 2010.ResultsTwenty extremities had a return to nearly normal function within twelve weeks after nailing. According to Rommens criteria excellent results seen in 79.2%, moderate 16.7%, poor 4.1%. The mean Constant-Murley score improved from pre operative 45.9 ± 17.6 to 79.1 ± 12.6 (p < 0.001) post operative.ConclusionInterlocking intramedullary nailing of the humerus provides immediate stability and can be accomplished with a closed technique, brief operative time, and minimum morbidity, with a resultant early return of function to the extremity.LEVEL OF EVIDENCE: iii retrospective cohort study.