Current concepts in the treatment of proximal humerus nonunions: a review

Objective:  To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database...

Full description

Saved in:
Bibliographic Details
Main Author: Lyubomir Rusimov
Format: Article
Language:English
Published: Bulgarian Orthopaedics and Trauma Association 2025-04-01
Series:Journal of the Bulgarian Orthopaedics and Trauma Association
Subjects:
Online Access:https://www.jbota.org/index.php/jbota/article/view/160
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850066922621632512
author Lyubomir Rusimov
author_facet Lyubomir Rusimov
author_sort Lyubomir Rusimov
collection DOAJ
description Objective:  To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database using the keywords “proximal humerus” and“nonunion” for a period covering the last ten years was conducted. The search was performed in November,2024 to include the most recent data available in the literature.Conclusions: Proximal humerus nonunion (PHN) is a relatively rare complication following PHFs. The risk of its occurrence is higher in PHFs with medial cortex insufficiency and fractures initially displaced into varus. Poor reduction and lack of fixation stability due to the surgical technique, along with patient-related factors such as smoking, further increase the risk of developing PHN. Researches on the treatment methods involving open reduction and internal fixation (ORIF) for PHN are heterogeneous, with a limited number of studies and  small number of patients, and no method has been established as the gold standard. Regardless of the ORIF method, augmentation with autograft or allograft appears to be mandatory. Compared to ORIF, prosthetic treatment for PHN yields poorer functional outcomes and higher rates of complications and reoperations, regardless of prosthesis type .
format Article
id doaj-art-0d6ef3aabe2b42e3a6791e28109c8cff
institution DOAJ
issn 0473-4378
2815-3715
language English
publishDate 2025-04-01
publisher Bulgarian Orthopaedics and Trauma Association
record_format Article
series Journal of the Bulgarian Orthopaedics and Trauma Association
spelling doaj-art-0d6ef3aabe2b42e3a6791e28109c8cff2025-08-20T02:48:34ZengBulgarian Orthopaedics and Trauma AssociationJournal of the Bulgarian Orthopaedics and Trauma Association0473-43782815-37152025-04-0162110.58542/jbota.v62i1.160Current concepts in the treatment of proximal humerus nonunions: a reviewLyubomir Rusimov0Second Clinic of Orthopaedics and Traumatology, University Multiprofile Hospital for Active Treatment and Emergency Medicine "N. I. Pirogov", Sofia, Bulgaria Objective:  To review contemporary concepts regarding the etiology, classifications, and treatment of nonunion following proximal humerus fractures (PHFs). Materials and Methods: For the arrangement of this narrative non-systematic review, an exploratory search in the MEDLINE (via PubMed) database using the keywords “proximal humerus” and“nonunion” for a period covering the last ten years was conducted. The search was performed in November,2024 to include the most recent data available in the literature.Conclusions: Proximal humerus nonunion (PHN) is a relatively rare complication following PHFs. The risk of its occurrence is higher in PHFs with medial cortex insufficiency and fractures initially displaced into varus. Poor reduction and lack of fixation stability due to the surgical technique, along with patient-related factors such as smoking, further increase the risk of developing PHN. Researches on the treatment methods involving open reduction and internal fixation (ORIF) for PHN are heterogeneous, with a limited number of studies and  small number of patients, and no method has been established as the gold standard. Regardless of the ORIF method, augmentation with autograft or allograft appears to be mandatory. Compared to ORIF, prosthetic treatment for PHN yields poorer functional outcomes and higher rates of complications and reoperations, regardless of prosthesis type . https://www.jbota.org/index.php/jbota/article/view/160Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft;
spellingShingle Lyubomir Rusimov
Current concepts in the treatment of proximal humerus nonunions: a review
Journal of the Bulgarian Orthopaedics and Trauma Association
Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft;
title Current concepts in the treatment of proximal humerus nonunions: a review
title_full Current concepts in the treatment of proximal humerus nonunions: a review
title_fullStr Current concepts in the treatment of proximal humerus nonunions: a review
title_full_unstemmed Current concepts in the treatment of proximal humerus nonunions: a review
title_short Current concepts in the treatment of proximal humerus nonunions: a review
title_sort current concepts in the treatment of proximal humerus nonunions a review
topic Key words: proximal humerus fractures, nonunion, locking plate, intramedullary nail, allograft, autograft;
url https://www.jbota.org/index.php/jbota/article/view/160
work_keys_str_mv AT lyubomirrusimov currentconceptsinthetreatmentofproximalhumerusnonunionsareview