Table 2.
Comparison with other studies in the literature where fibular graft was used in treating humeral non-unions.
| Study | No of Subjects (FG Used) | Properties of Study; Procedure Done | Average Age (yrs) | Mean Interval of Nonunion | Mean Follow Up (months) | Duration of Union (months) | Results | Complications |
|---|---|---|---|---|---|---|---|---|
| Wright et al.7 | 9 (9) | 8 cases of failed fixation; DCP + Allograft in 4 pts & Autograft in 5 pts, also biomechanical analysis of fibular graft assessed | 49.8 (28–67) | 16.25 (3.5–72) months | 38.6 (12-74) | 3.37 (3-4) | 8 achieved union | 1-nonunion, 1- radial nerve palsy, 1-supracondylar fracture, 1- peroneal nerve palsy |
| Farouk O et al.38 | 10 (10) | 3 cases of failed plating; DCP + FG | – | 16 (6–36)months | 10 (8–16) | 4 (3–6) | 10 achieved union | stress supracondylar fracture |
| Vidhyadara S et al.39 | 6 (6) | in osteoporotic humerus, 1 case of failed fixation; DCP + FG | 65.33 (54–84) | 13.33 (7–26) months | 15.83 (11–24) | 3 | all achieved union DASH score 84 ± 5 to 28 ± 13 | 1- transient peroneal nerve palsy, 1-iatrogenic splinter, 2-superficial infection |
| Kilic A et al.34 | 4 (4) | 3 cases of failed fixation; DCP + FG | 67 (65–69) | – | 48 (36–72) | 3.2 (3–4) | union in all DASH score ≥58–17 | nil |
| Erder ER et al.35 | 5 (5) | 2 cases of failed plating; LCP + FG | 49.2 | 70 (24–128) months | 22.8 (12–36) | 5 (4–5.5) | union in all with Constant Murley score of 88 | nil |
| Gopisankar et al.36 | 7 (7) | infected nonunions with mean previous surgery of 2.7; DCP + FG | 40 (29–59) | – | 15 (13–24) | 5.4 (4–8) | 6 achieved normal function, 1 has brachial plexus injury with poor outcome | 2 case of wound infection |
| Padhye KP et al.15 | 35 (4) | infected, noninfected, osteoporotic nonunion included. Ilizarov, plating ± BG | 42 (24–71) | – | 16 (6–60) | infected-6.5, noninfected − 5, osteoporotic- 10 | union achieved in all | pin site complications in Ilizarov cases |
| Willis MP et al.37 | 20 (20) | 10 cases of failed fixation, LCP+ fibular allograft | 61 (44–81) | – | 36 (12–94) | 4 | 19 achieved union with normal daily activities | 1- nonunion, 3-adhesive capsulitis of shoulder |
| Kumar MN et al.23 | 24 (3) | all cases of failed fixation, LCP ± BG | 41.04 (24–57) | 26.3 (7–276) months | 39 (27–65) | – | 23 attained union, | 2- delayed union,1- persistent nonunion, 2- transient radial nerve palsies |
| Our Study (2015) | 17 (17) | 17 cases are previously operated, 2 cases operated twice | 40.11 (26–57) | 53.17 (6–168) months | 33.41(12–94) | 3.5 (3–5) | 16 attained union with DASH score ≥59.14–23.39 | 1- implant bending, 1- transient radial nerve palsy, 1- transient ulnar nerve palsy, 1-iatrogenic splinter during implant removal. |
(FG – Fibular Graft, BG – Bone Graft, DCP – Dynamic Compression Plate, LCP – Locking Compression Plate.