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Purpose: Non-unions after humeral shaft fractures are seen frequently in clinical practice at about 2-10% after conservative management and 30% after surgical treatment. Non-union, displacement of structures and fixation failure can be hazardous complications. The purpose of our study was to evaluate the outcomes of an on-lay bone graft strut construction with bone chips as grafting augmentation in the management of aseptic non-unions of the humeral shaft., Methods: From 124 eligible patients with a humeral shaft non-union, we included 48 patients. In all cases an anterolateral humeral approach was used, with an on-lay bone graft using an allograft strut construction and with bone substitute augmentation in the non-union gap. To assess the bone healing on radiographs, we used the non-union scoring system according to Whelan. Patients were followed with objective and subjective scores., Results: In all 48 patients we achieved full bone healing without major complications. The average period of union was 124 days. In 40 cases after healing the alignment was neutral, valgus deformation occurred in 6 cases a varus deformation in 2 cases. At twelve months after surgery, all patients recovered with satisfactory range of motion of shoulder and elbow and a good quality of life, without any radial nerve palsies or other major complications., Conclusion: Given the satisfactory results of full bone healing, recovery of the range of motion and the lack of major complications as seen in this study, we find that plating with supporting allograft as a good choice of treatment in the cases of aseptic non-union of the humeral shaft., (© 2019 Delhi Orthopedic Association. All rights reserved.)

Introduction: Non-union after humeral shaft fractures are seen frequently in clinical practice. The incidence is 2-10% after conservative management and up to 30% after surgical treatment. The purpose of this study is to evaluate the outcomes of plate-and-bone-strut-allograft technique with bone chip augmentation for aseptic non-unions of the distal third of the humerus., Materials and Methods: 26 consecutive cases were treated using a trans -triceps approach. The non-union was fixed with a 4.5 mm Locking Compression Plate combined with a strut bone allograft at the anterior part of the humerus and bone chips. All patients underwent the same rehabilitation protocol of 12 weeks. Clinical evaluation took place 12 months after surgery with the Mayo elbow score and Oxford elbow score., Results: Complete bone healing without complications was achieved in all 26 patients. The average period of radiographic union was 106 days. The average range of flexion-extension was 108° (94°-180°) and pro-supination was 159° (102°-180°). Twelve months after surgery, average Mayo elbow score was 86 (68-100) and the Oxford elbow score was 83 (52-100)., Conclusion: The plate-and-bone-strut-allograft technique with bone chip augmentation in distal humeral shaft for aseptic non-unions resulted in union of all cases. No adverse events related to the surgery or the materials used were documented., (© 2019 Delhi Orthopedic Association. All rights reserved.)

Introduction: The biceps brachii lesion needs to be treated surgically. A modified two incisions technique is proposed and reviewed. Material and Methods: All patients were treated with the same technique. The outcomes were measured with the Quick-DASH Score (QDS), and the Mayo Elbow Performance Score (MEPS). Postoperative complications and distal biceps tendon strength were registered also., Results: At one year from the trauma, the QDS and the MEPS were excellent in all patients. 72.97% fully recovered and returned to work after 6 months from the trauma., Discussion: This technique, thanks to its preservation of anatomical structures, provides great outcomes.