Functional Outcomes of Gap Non-Union Humerus Fractures Treated with Fibular Strut Graft, Iliac Crest Graft, and Locking Compression Plate.

Introduction: The humeral shaft gap non-union treatment surgically after unsuccessful fixation is difficult. In this study, the functional outcome of unsuccessful fixation of humeral shaft gap non-unions using a locking compression plate (LCP), fibular strut graft, and iliac bone graft was evaluated.

Case Report: After taking ethical approval, we studied 10 patients with humeral shaft gap non-unions with unsuccessful surgical fixation treated with open reduction and internal fixation using LCP with fibular strut graft and iliac cancellous bone graft. The study duration was from January 2022-January 2024. The mean time from non-union was 7 months. Disabilities of the arm, shoulder, and hand (DASH) scores improved significantly from a pre-operative average of 59.2 ± 7.3 to a mean final score of 24.6 ± 4.8 reflecting a mean improvement of 34.6 with no complications.

Conclusion: This study shows that LCP with fibular strut graft and iliac bone grafts is a good alternative for diaphyseal humerus gap non-union along with statistically significant improvement in functional outcome, with union seen in all cases. This construct augments biomechanical stability and good biological healing in these gap non-unions.