Atrophic nonunion of humeral diaphysis treated with locking plate and recombinant bone morphogenetic protein: nine cases.

Nonunions of the humerus are debilitating for patients and challenging for surgeons. We retrospectively reviewed our first 9 humeral nonunions treated with a locking plate and commercially available recombinant bone morphogenetic protein. At latest follow-up, 8 patients showed clinical and radiographic signs of union. One patient had a persistent (11-year) nonunion that failed to unite at 1 year, despite new bone formation, and underwent revision with the same technique. The reported technique is a useful part of the surgeon's armamentarium in treating difficult humeral nonunions. We found a high union rate with an acceptably low complication rate in this difficult population.