Acta Ortopédica Mexicana

Montes de Oca-Gil JA, Morales-De los Santos R
Dyaphyseal pseudoarthroses of the humerus. Treatment by “wave” screw-plating and bone grafting. Report of six cases
Acta Ortop Mex 2002; 16 (2)

Language: Español
References: 15
Page: 96-101
PDF: 543.64 Kb.

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Objective. To evaluate results of dyaphyseal peudoarthrosis treatment by “wave” screw-plating and bone grafting in the humerus. Material and methods. A small series of 6 cases with an average age of 45.5 years (24 to 56) is reported: one out of the 6 was a Gustilo-III open fracture and it was closed in the remaining 5 cases. A range of 2 to 5 failed operations (av. 3.3) had been performed in every patient for fracture treatment before admission to our hospital: 2 of them had injury of the radial nerve, both produced in the last surgery, one by standard plating and one by an external fixator. All of 6 pseudoarthrosis were treated in our hospital by screw-wave plating and bone grafting. Results. Bone union was obtained in all 6 cases after an average of 6 months. Improvement in hand function was obtained after tendon transfers in one case of radial nerve injury being the remaining case in schedule for same treatment. Conclusion. Wave plating has demonstrated the advantage of an anatomical space between the bone plasty and metal at the point of wave which is useful for allowing new vascular supply from the surrounding tissue into the bone, since no material interferes with circulation around the damaged bone.

Key words: humerus, pseudoarthrosis, screw, plate, fixation, fracture.


  1. Arrocha NH. Tesis de postgrado. Tratamiento quirúrgico de la pseudoartrosis diafisaria de húmero con placa DCP ancha más aporte óseo. México, D.F., 1990: 1-25.

  2. Barquet A, Fernández A, Luvizio J, Masliah R. A combined therapeutic protocol for aseptic non-union of the humeral shaft: A report of 25 cases. J Trauma 1989; 29(1): 95-8.

  3. Blatter G, Weber BG. Wave plate osteosynthesis as a salvage procedure. Arch Orthop Trauma 1990; 109: 330-3.

  4. Brunner CF, Weber BG. Special techniques in internal fixation. 3, Nueva York, Springer Verlag, 1982; 145-61.

  5. Cervelatti C, Montanari G, Masetti G, Carpanelli F. The Ilizarov method for the treatment of non-union in the humerus. Chir Organi Mov 1990; 75: 115-20.

  6. Foster RJ, Watch AW, Green TM. Internal fixation of fractures and non-union of the humeral shaft. J Bone Joint Surg 1985; 67-A (6): 857-64.

  7. Kerneziz IA. Biomechanical considerations in “biological” femoral osteosynthesis: An experimental study of the “bridging” and “wave plating techniques” (in process citation). Arch Orthop Trauma Surg 2000; 120(5-6): 272-5.

  8. Lammens J, Bauduin G, Driesen R, Moens P, Stuic J, De Ment L, Fabry G. Treatment of non-union of the humerus using the Ilizarov external fixator. Clin Orthop Rel Res 1998; 353: 223-30.

  9. Modabber MR, Jupiter JB. Operative management of the diaphyseal fractures of the humerus plate versus nail. Clin Orthop Rel Res 1998; 347: 93-104.

  10. Müller ME. Manual de osteosíntesis. 3, Alemania, Springer-Verlag Ibérica, 1993; 68-73.

  11. Pérez PM. Tesis de postgrado. Evaluación de resultados en el tratamiento de pseudoartrosis de diáfisis humeral con DCP ancha más aplicación de injerto óseo autólogo. México, D.F., 1996: 1-30.

  12. Ring D, Jupiter JB, Sanders RA, Quintero J, Santoro MV, Ganz R, Marti RK. Complex non-union of fractures of the femoral shaft treated by wave-plate osteosynthesis. J Bone Joint Surg Br 1997; 79(2): 289-94.

  13. Rodríguez GS, Velázquez M. Tratamiento de la pseudoartrosis de húmero con clavo intramedular fijo al hueso con pernos. Rev Mex Ortop Traum 1993; 7(1): 45-7.

  14. Rodríguez MR. Tesis de postgrado. Pseudoartrosis atrófica humeral tratamiento quirúrgico mediante osteosíntesis estable más aporte de hidroxiapatita coralina HAP-200 como sustituto de aporte óseo. México, D.F., 1998: 1-27.

  15. Weber BG, Cech O. Pseudoartrosis. 2, Alemania, Científica-Médica, 1996: 129-41.