TREATMENT OF NONUNION OF THE HUMERUS USING THE ILIZAROV EXTERNAL FIXATOR

Ilizarov's method of monofocal compression was used in 30 humeri with a diaphyseal pseudarthrosis, Twenty-one patients had previous surgery but had loosening of the osteosynthesis material, Nine patients initia lly were treated with a hanging cast, resulting in interfragmentary di straction. Fourteen nonunions were hypertrophic, and 16 were atrophic, of which six were infected. A complete circular frame was used only i n the first nine patients, whereas the remaining 21 patients were trea ted with the modified semicircular fixator, Union was obtained in all but two patients, with an average consolidation time of 4.5 months (ra nge, 2.5-10 months). No patient required additional bone grafting. Apa rt from superficial pin tract infection seen in most of the patients, three had a minor temporary sensory neurologic problem. Four patients experienced a second fracture after removal of the fixator that requir ed a second application of an Ilizarov frame. Although similar results with regard to union are reported after plate osteosynthesis, there w as no radial nerve palsy or deep infection in this series, indicating that the treatment by the Ilizarov technique is associated with less c omplications. The authors' findings suggest that the Ilizarov method i s a reliable treatment for humeral nonunions, even after multiple prev ious operations or in the event of infection.