Proximal Humeral Nonunions: Surgical Technique with Fibular Strut Allograft and Fixed-Angle Locked Plating

Nonunions of the proximal humerus, although uncommon, are challenging for even the experienced upper extremity specialist. The bone quality is typically poor, and the proximal bone stock is limited. These patients often possess multiple comorbidities contributing to the development of the nonunion. Although many treatment options exist, results have been mixed with no definitive surgical technique identified. The technique presented is a safe and reliable method for treatment of nonunions of the proximal humerus using an inlay fibular strut allograft, compression through the nonunion site with heavy suture, and secure fixation with a fixed-angle locked plate.