Md Mohiuddin Aslam
A fracture bone usually heals by the formation of new bone at the fracture site. Occasionally, only fibrous tissue is formed, when this happens both surgeon & patient are disappointed. The bone is a specialized form of connective tissue may account for its ability to heal by the formation of new bone. The humerus is a long bone connecting two important joints of upper limb- which has wide range of movement having very little bony stability in shoulder joint and distal elbow joint which is a uni axial hinge joint. This prospective study of "treatment of nonunion of humeral shaft fracture by locking plate and screws augmented with autogenous cancellous bone grafting" was carried out during the period of 1st December 2011 to 31th May 2013 at National Institute of Traumatology and Orthopeadic Rehabilitation (NITOR) Dhaka, Bangladesh. Sample size will be calculated by using following statistics = 384. Purposive sampling (non-randomized) according to availability of the patients and strictly considering the inclusion and exclusion criteria. Data will be collected with a pre-tested structured questionnaire containing history, clinical examination, laboratory investigations, pre-operative, per-operative, postoperative follow up findings and complications. 16 Patients were selected by using non randomized sampling method. The age ranges from 28-60 years. The mean age of occurrence was 38.19 (+10.04) years. Motor vehicle accident was the commonest cause of fracture found in 81.25% cases. Second most common cause was fall from height (12.50%). Right side involvement was more (62.50%). Among the affected people serTce holders and shopkeepers were commonest (25% each), next were businessmen and farmers (18.75% each). The mean union time was 16.38 (+2.78) weeks. Postoperative complications were noticed such as wound infection (6.25%) and shoulder pain (6.25%). There was no complication (81.25%). Functional outcome of this treatment was analyzed by Constant and Murley scoring (1999). Excellent functional outcome was found in 5 (31.25%) cases, good in 9 (56.25%) cases, fair in 1 (6.25%) case and poor in 1 (6.25%) case. Regarding the final outcome satisfactory result was found in 14 (87.50%) cases and unsatisfactory result in 2 (12.50%) cases. Based on the results shown above it is concluded that "treatment of nonunion of humeral shaft fracture by locking plate and screws augmented with autogenous cancellous bone grafting" is an effective modality of treatment for the nonunion of humeral shaft fracture and is especially recommended in osteoporotic bones and elderly patients with compromised bone quality.
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