Outcomes of Post-traumatic Infected Non-union of the Humerus Managed by Hybrid Ring Fixators.

Aims: The present study evaluated the functional and clinico-radiological outcomes of management of septic non-union of the humeral fractures managed with hybrid ring fixator. Patients and methods: A total of 18 patients with post-traumatic infected non-union of humerus were included. The mean age was 30.8 years and mean duration of presentation after injury was 19.1 weeks. Mean follow-up duration was 28.11 months and mean time of fixator removal was 25.28 weeks. Bone and functional results were evaluated using the modified Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria, and disability of arm, shoulder and hand (DASH) scores. Results: Bone union was achieved primarily in 16 (88.8%) patients. According to modified ASAMI criteria, the bone results were excellent, good, fair, and poor in 9 (50%), 7 (38.9%), 0 and 2 (11.1%) patients, respectively, whilst functional results were excellent, good, fair, and poor in 11 (61.1%), 5 (27.8%), 0 and 2 (11.1%) patients, respectively. The mean DASH score was 15.27 (5.8-50) at the final follow-up. The mean limb length shortening was 2.67 cm (2-5 cm), whereas malunion of more than 15 ℃ angulation was observed in three patients. Conclusions: Hybrid ring fixator is very effective in management of post-traumatic infected non-union of the humerus. Good-to-excellent bone and functional results can be achieved in majority of patients. Elbow stiffness and superficial pin tract infections are common problems encountered by patients.

Level of evidence: IV, A Retrospective study.