We sought to determine time to union of diaphyseal humeral fractures treated with plate fixation and to identify underlying contributing factors.
A retrospective cohort study of patients at a Level 1 trauma center from January, 2006 to December, 2016 was performed. The clinical intervention studied was surgical plate fixation, and the main outcome measure was time to union.
One hundred and thirty-five patients were included, with mean age of 40.67 (range: 18-90) and body mass index of 29.8 (range: 18.5-74.4). The mean time to union was 19.0 wk with a nonneurological complication rate of 8.9% (eight nonunions [5.95%], one malunion, one implant failure, and two infections). There was no correlation between age or body mass index and time to union. No difference was seen in time to union when comparing males versus females (17.9 vs. 20.1; P=0.3477), smokers versus nonsmokers (22.8 vs. 20.3, P=0.4237), anterior versus posterior approach (18.5 vs. 19.3; P=0.5798), and bridging versus rigid technique (17.6 vs. 19.6; P=0.4453). There was no difference in time to union between proximal, middle, or distal diaphyseal fracture location. There was a trend toward longer time to union in open fractures versus closed and a significantly increased risk of nonunion in open fractures (22.2% vs. 3.4%; P=0.0110). Overall time to union is slightly increased when compared to previously published data.
Open fracture results in both increased time to union and rate of nonunion after plate fixation. There is no difference in time to union between surgical approaches and techniques, as well as in age, body mass index, gender, smoking, or fracture location.
Level of Evidence: