Is double plate fixation A remedy for thetreatment of humeral shaft nonunions? Comparative presentations

In this study, our aim is to compare the clinical and functional results of patients who underwent single-plate osteosynthesis and double-plate osteosynthesis in the treatment of humeral nonunions. Diagnosed with humeral body nonunion in our clinic between 2009-2020; Patients who received single-plate and double-plate osteosynthesis were evaluated retrospectively. Patients under 18 years of age, those who underwent intramedullary nailing, those treated with external fixators, those with acute or previous infections, patients with radial nerve damage, and patients whose data could not be reached were not included in the study. Average follow-up time was 23.6 months. Surgical treatment was performed using anterolateral or posterior approaches. In the surgical approach, the radial nerve was found and protected, the segment ends were debrided and decorticated. Fixation was achieved with a single plate or a double plate. Autogenous bone grafting from the iliac crest was applied to each patient. Single-plate osteosynthesis and double-plate osteosynthesis methods were compared in terms of union rates, time to union, functional results and complications. Functional results were evaluated with Quick Disability of shoulder arm and hand scale(QuickDASH), Vizuel Analog Scala(VAS) and Stewart and Hundley classifications. 45 patients were included in the study and single plate application was applied to 28 of them and osteosynthesis was applied to 17 patients with double plate. The rates of fusion were 89.3% in cases with a single plate and 100% in cases with double plates. The mean time of union was 5.4±1.04 months in patients with single plate and 3.79±1.08 months in patients with double plates. In both groups, radial nerve area was seen in 1 patient and superficial infection was seen in 1 patient each. There was no statistically significant difference between the rates of union for the two methods. Union time was significantly shorter in the double-plate osteosynthesis group. There was no significant difference in terms of functional results and complications.