Factors associated with humeral shaft nonunion

Background The primary aim was to identify patient and injury factors independently associated with humeral diaphyseal fracture nonunion after nonoperative management. secondary determine the effect of management (operative/nonoperative) on nonunion. Methods From 2008-2017, a total 734 shaft fractures (732 consecutive skeletally mature patients) were retrospectively identified from trauma database. Follow-up available for 663 (662 patients, 90%) that formed study cohort. Patient characteristics recorded. There 523 patients (79%) managed nonoperatively 139 (21%) operatively. Outcome (union/nonunion) determined medical records radiographs. Results median age at 57 (range 16-96) years 54% (n = 359/662) female. Median follow-up 5 (1.2-74) months. Nonunion occurred in 22.7% 119/524) injuries. Multivariate analysis demonstrated preinjury nonsteroidal anti-inflammatory drugs (NSAIDs; odds ratio [OR] 20.58, 95% confidence interval [CI] 2.12-199.48; P .009) glenohumeral arthritis (OR 2.44, CI 1.03-5.77; .043) an increased risk Operative fixation lower (2.9%, n 4/139) compared nonoperative/operative 9.91, 3.25-30.23; < .001). Based these findings, would need undergo operative order avoid 1 Conclusions Preinjury NSAIDs following fracture. independent factor most strongly Targeting early at-risk may reduce rate morbidity delayed definitive