Results of Locking Compression Plate (LCP) Fixation in Humeral Shaft Nonunion

Although nonoperative treatment is indicated & successful for the majority of diaphyseal humeral fractures, nonunion is not rare condition. The prevalence of nonunion as a complication of conservative treatment has been reported to be as high as 15%. Locking compression plate combined with autogenous cancellous bone grafting can result in reliable healing of these humeral nonunion with excellent functional outcome. This prospective observational study was conducted September, 2016 to October, 2018 at National Institute of Traumatulogy & Orthopaedic Rehablitation, Dhaka & Mymensingh Medical College, Mymensingh, Bangladesh. Fifteen (15) patients with non-united humeral shaft fractures were treated by open reduction and internal fixation by LCP with autogenous cancellous bone graft. Detailed clinical conditions of all patients, duration of injury, technical difficulty with the implant, hospital stay period were recorded. Follow up period was 6 months. The patients were evaluated clinically and radiologically for outcomes. The progresses of healing as well as occurrence of complications were recorded. The modified Constant and Murley score of functional assessment was used for shoulder & elbow function. Age of the study patients was ranged 20-50 years. Maximum patients were male 12. Mode of injury were found road traffic accident 8 cases, fall from height 5 cases. Right side was injured in 9 patients. Atrophic nonunion was found in 13 patients and hypertropic in 2 patients. The mean union time was 15 weeks. Only one patient had wound infection and 2 patients had shoulder stiffness. Functional outcome which constituted 90% satisfactory results in 13 cases according to modified Constant & Murley scoring system. Union rate was 100%. Therefore, LCP fixation with autogenous cancellous bone graft is a standard treatment method for nonunion of humeral shaft fracture.