{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:21:14Z","timestamp":1781374874155,"version":"3.54.1"},"reference-count":86,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To document union rate, complications and patient-reported outcomes after open reduction and internal fixation (ORIF), with and without bone grafting (BG), for humeral diaphyseal nonunion after failed nonoperative management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>University teaching hospital.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients and Intervention:<\/jats:title>\n            <jats:p>From 2008 to 2017, 86 consecutive patients [mean age 59 years (range 17\u201386), 71% (n = 61\/86) women] underwent nonunion ORIF (plate and screws) at a mean of 7 months postinjury (range 3\u201321.5). Eleven (13%) underwent supplementary BG.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Union rate and complications for 83 patients (97%) at a mean of 10 months (3\u201361). Patient-reported outcomes (QuickDASH, EQ-5D, EQ-VAS, SF-12, satisfaction) for 53 living, cognitively-intact patients (78%) at a mean of 4.9 years (0.3\u20139.2).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Ninety-three percent (n = 77\/83) achieved union after nonunion ORIF. Complications included recalcitrant nonunion (7%, n = 6\/83), iatrogenic radial nerve palsy (6%, n = 5\/83), infection (superficial 7%, n = 6\/83; deep 2%, n = 2\/83), and iliac crest donor site morbidity (38%, n = 3\/8). The union rate with BG was 78% (n = 7\/9) and without was 95% (n = 70\/74; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.125), and was not associated with the nonunion type (atrophic 91%, n = 53\/58; hypertrophic 96%, n = 24\/25; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.663). Median QuickDASH was 22.7 (0\u201395), EQ-5D 0.710 (\u22120.181-1), EQ-visual analog scale 80 (10\u2013100), SF-12 physical component summary 41.9 (16\u201360.5), and mental component summary 52.6 (18.7\u201367.7). Nineteen percent (n = 10\/53) were dissatisfied with their outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>ORIF for humeral diaphyseal nonunion was associated with a high rate of union. Routine BG was not required and avoided the risk of donor site morbidity. One in 5 patients were dissatisfied despite the majority achieving union.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002032","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T23:04:59Z","timestamp":1626476699000},"page":"414-423","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Open Reduction and Internal Fixation for Humeral Shaft Nonunion: Bone Grafting Is Not Routinely Required and Avoids Donor Site Morbidity"],"prefix":"10.1097","volume":"35","author":[{"given":"William M.","family":"Oliver","sequence":"first","affiliation":[{"name":"Edinburgh Orthopaedics \u2013 Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel G.","family":"Molyneux","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics \u2013 Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy O.","family":"White","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics \u2013 Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas D.","family":"Clement","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics \u2013 Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Duckworth","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Keating","sequence":"additional","affiliation":[{"name":"Edinburgh Orthopaedics \u2013 Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"596","DOI":"10.2106\/00004623-197759050-00004","article-title":"Functional bracing of fractures of the shaft of the humerus","volume":"59","author":"Sarmiento","year":"1977","journal-title":"J Bone Joint Surg Am."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2106\/00004623-198264010-00002","article-title":"Diaphyseal fractures of the humerus treated with a ready-made fracture brace","volume":"64","author":"Balfour","year":"1982","journal-title":"J Bone Joint Surg Am."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00590-012-0982-3","article-title":"Study on outcome of fracture shaft of the humerus treated non-operatively with a functional brace","volume":"23","author":"Kapil Mani","year":"2013","journal-title":"Eur J Orthop Surg Traumatol."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/BF00435647","article-title":"Humeral shaft fractures treated with a ready-made fracture brace","volume":"106","author":"Naver","year":"1986","journal-title":"Arch Orthop Trauma Surg."},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"607","DOI":"10.2106\/00004623-198870040-00018","article-title":"Diaphyseal fractures of the humerus. Treatment with prefabricated braces","volume":"70","author":"Zagorski","year":"1988","journal-title":"J Bone Joint Surg Am."},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1302\/0301-620X.72B2.2312570","article-title":"Functional bracing for comminuted extra-articular fractures of the distal third of the humerus","volume":"72","author":"Sarmiento","year":"1990","journal-title":"J Bone Joint Surg Br."},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/00005131-199705000-00011","article-title":"Functional treatment of humeral shaft fractures: indications and results","volume":"11","author":"Wallny","year":"1997","journal-title":"J Orthop Trauma."},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s004020050465","article-title":"Functional results of braced humeral diaphyseal fractures: why do 38% lose external rotation of the shoulder?","volume":"120","author":"Fjalestad","year":"2000","journal-title":"Arch Orthop Trauma Surg."},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"478","DOI":"10.2106\/00004623-200004000-00003","article-title":"Functional bracing for the treatment of fractures of the humeral diaphysis","volume":"82","author":"Sarmiento","year":"2000","journal-title":"J Bone Joint Surg Am."},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1067\/mse.2002.121634","article-title":"The results of functional (Sarmiento) bracing of humeral shaft fractures","volume":"11","author":"Koch","year":"2002","journal-title":"J Shoulder Elbow Surg."},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/s00402-002-0403-x","article-title":"Functional treatment of the distal third humeral shaft fractures","volume":"122","author":"Pehlivan","year":"2002","journal-title":"Arch Orthop Trauma Surg."},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.jse.2017.07.001","article-title":"Humeral shaft fractures: union outcomes in a large cohort","volume":"26","author":"Harkin","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/00003086-200105000-00026","article-title":"Salvage of humeral nonunions with onlay bone plate allograft augmentation","volume":"386","author":"Hornicek","year":"2001","journal-title":"Clin Orthop Relat Res."},{"key":"R14-20250614","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.2106\/00004623-200208000-00005","article-title":"Open reduction and internal fixation of humeral nonunions: a biomechanical and clinical study","volume":"84","author":"Rubel","year":"2002","journal-title":"J Bone Joint Surg Am."},{"key":"R15-20250614","doi-asserted-by":"crossref","first-page":"2314","DOI":"10.1016\/j.injury.2015.09.041","article-title":"Union rate after operative treatment of humeral shaft nonunion - a systematic review","volume":"46","author":"Peters","year":"2015","journal-title":"Injury."},{"key":"R16-20250614","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S0020-1383(75)80007-6","article-title":"Non-union in fractures of the humeral shaft","volume":"7","author":"Loomer","year":"1975","journal-title":"Injury."},{"key":"R17-20250614","doi-asserted-by":"crossref","first-page":"857","DOI":"10.2106\/00004623-198567060-00005","article-title":"Internal fixation of fractures and non-unions of the humeral shaft. Indications and results in a multi-center study","volume":"67","author":"Foster","year":"1985","journal-title":"J Bone Joint Surg Am."},{"key":"R18-20250614","first-page":"1393","article-title":"Revision with dynamic compression plate and cancellous bone graft for aseptic nonunion after surgical treatment of humeral shaft fracture","volume":"67","author":"Lin","year":"2009","journal-title":"J Trauma."},{"key":"R19-20250614","first-page":"183","article-title":"Uninfected nonunion of the humeral diaphyses: review of 21 patients treated with shingling, compression plate, and autologous bone graft","volume":"96","author":"Bernard de Dompsure","year":"2010","journal-title":"Rev Chir Orthop Traumatol."},{"key":"R20-20250614","first-page":"299","article-title":"Open reduction and internal fixation of humeral non-unions: radiological and functional results","volume":"77","author":"Abalo","year":"2011","journal-title":"Acta Orthop Belg."},{"key":"R21-20250614","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4103\/0019-5413.108899","article-title":"Outcome of locking compression plates in humeral shaft nonunions","volume":"47","author":"Kumar","year":"2013","journal-title":"Indian J Orthop."},{"key":"R22-20250614","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1177\/230949901302100313","article-title":"Plating, nailing, external fixation, and fibular strut grafting for non-union of humeral shaft fractures","volume":"21","author":"Padhye","year":"2013","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"suppl 2","key":"R23-20250614","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1016\/S0020-1383(17)30492-8","article-title":"Recalcitrant aseptic atrophic non-union of the shaft of the humerus after failure of surgical treatment: management by excision of non-union, bone grafting and stabilization by LCP in different modes","volume":"48","author":"Babhulkar","year":"2017","journal-title":"Injury."},{"key":"R24-20250614","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/00003086-198706000-00030","article-title":"Nonunion of the humeral shaft","volume":"219","author":"Healy","year":"1987","journal-title":"Clin Orthop Relat Res."},{"key":"R25-20250614","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/00005373-198901000-00020","article-title":"A combined therapeutic protocol for aseptic nonunion of the humeral shaft: a report of 25 cases","volume":"29","author":"Barquet","year":"1989","journal-title":"J Trauma."},{"key":"R26-20250614","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/00005131-199610000-00008","article-title":"Management of humeral nonunion after the failure of locking intramedullary nails","volume":"10","author":"McKee","year":"1996","journal-title":"J Orthop Trauma."},{"key":"R27-20250614","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/S0020-1383(98)00109-0","article-title":"A method of treatment of non-union of humeral shaft fractures following treatment by locked intramedullary nail: a report of three cases","volume":"29","author":"Emmerson","year":"1998","journal-title":"Injury."},{"key":"R28-20250614","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1302\/0301-620X.82B6.0820867","article-title":"Atrophic ununited diaphyseal fractures of the humerus with a bony defect","volume":"82","author":"Ring","year":"2000","journal-title":"J Bone Joint Surg Br."},{"key":"R29-20250614","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/s00264-002-0354-4","article-title":"Non-union of the humeral shaft treated by internal fixation","volume":"26","author":"Kumar","year":"2002","journal-title":"Int Orthop."},{"key":"R30-20250614","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/00005131-200202000-00007","article-title":"Humeral shaft nonunion: evaluation of uniform surgical repair in fifty-one patients","volume":"16","author":"Marti","year":"2002","journal-title":"J Orthop Trauma."},{"key":"R31-20250614","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S1726-4901(09)70138-8","article-title":"Treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone graft","volume":"68","author":"Hsu","year":"2005","journal-title":"J Chin Med Assoc."},{"key":"R33-20250614","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1302\/0301-620X.71B4.2768321","article-title":"Donor site pain from the ilium. A complication of lumbar spine fusion","volume":"71","author":"Summers","year":"1989","journal-title":"J Bone Joint Surg Br."},{"key":"R34-20250614","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/00005131-198909000-00002","article-title":"Morbidity at bone graft donor sites","volume":"3","author":"Younger","year":"1989","journal-title":"J Orthop Trauma."},{"key":"R35-20250614","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.2106\/JBJS.K.00961","article-title":"Prospective observational study of donor-site morbidity following anterior iliac crest bone-grafting in orthopaedic trauma reconstruction patients","volume":"94","author":"Loeffler","year":"2012","journal-title":"J Bone Joint Surg Am."},{"key":"R36-20250614","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1097\/00007632-199505000-00012","article-title":"Iliac crest bone graft harvest donor site morbidity: a statistical evaluation","volume":"20","author":"Banwart","year":"1995","journal-title":"Spine."},{"key":"R37-20250614","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/00003086-199608000-00037","article-title":"Complications of iliac crest bone graft harvesting","volume":"329","author":"Arrington","year":"1996","journal-title":"Clin Orthop Relat Res."},{"key":"R38-20250614","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/00003086-199706000-00011","article-title":"Autogenous iliac crest bone graft: complications and functional assessment","volume":"339","author":"Goulet","year":"1997","journal-title":"Clin Orthop Relat Res."},{"key":"R39-20250614","doi-asserted-by":"crossref","first-page":"716","DOI":"10.2106\/00004623-200205000-00003","article-title":"Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes","volume":"84","author":"Ahlmann","year":"2002","journal-title":"J Bone Joint Surg Am."},{"key":"R40-20250614","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/00007632-200301150-00008","article-title":"Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion","volume":"28","author":"Silber","year":"2003","journal-title":"Spine."},{"key":"R41-20250614","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1177\/107110070502600206","article-title":"Morbidity associated with anterior iliac crest bone grafting in foot and ankle surgery","volume":"26","author":"Deorio","year":"2005","journal-title":"Foot Ankle Int."},{"issue":"suppl","key":"R42-20250614","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1097\/01.bsd.0000112045.36255.83","article-title":"Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment","volume":"18","author":"Sasso","year":"2005","journal-title":"J Spinal Disord Tech."},{"key":"R43-20250614","first-page":"347","article-title":"Long-term functional outcome and donor-site morbidity associated with autogenous iliac crest bone grafts utilizing a modified anterior approach","volume":"67","author":"Singh","year":"2009","journal-title":"Bull NYU Hosp Joint Dis."},{"key":"R44-20250614","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/S0020-1383(00)00231-X","article-title":"Plate osteosynthesis for pseudarthrosis of the humeral shaft","volume":"32","author":"Te Velde","year":"2001","journal-title":"Injury."},{"key":"R45-20250614","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/BOT.0b013e318177eb23","article-title":"Shortening osteotomy and compression plating for atrophic humeral nonunions: surgical technique","volume":"22","author":"Brennan","year":"2008","journal-title":"J Orthop Trauma."},{"key":"R46-20250614","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s00264-009-0863-5","article-title":"Anterior plating as a surgical alternative in the treatment of humeral shaft non-union","volume":"34","author":"Livani","year":"2010","journal-title":"Int Orthop."},{"key":"R47-20250614","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2106\/JBJS.19.01115","article-title":"Healing the index humeral shaft nonunion: risk factors for development of a recalcitrant nonunion in 125 patients","volume":"102","author":"Wiss","year":"2020","journal-title":"J Bone Joint Surg Am."},{"issue":"suppl 1","key":"R48-20250614","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification compendium\u20132018","volume":"32","author":"Meinberg","year":"2018","journal-title":"J Orthop Trauma."},{"key":"R51-20250614","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1001\/jama.2020.3182","article-title":"Effect of surgery vs functional bracing on functional outcome among patients with closed displaced humeral shaft fractures: the FISH Randomized Clinical Trial","volume":"323","author":"R\u00e4m\u00f6","year":"2020","journal-title":"JAMA."},{"key":"R52-20250614","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jse.2014.05.009","article-title":"Nonoperative treatment of humeral shaft fractures revisited","volume":"24","author":"Ali","year":"2015","journal-title":"J Shoulder Elbow Surg."},{"issue":"suppl 2","key":"R53-20250614","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/S0020-1383(07)80005-2","article-title":"Definition and classification of fracture non-unions","volume":"38","author":"Fr\u00f6lke","year":"2007","journal-title":"Injury."},{"key":"R54-20250614","first-page":"1038","article-title":"Upper extremity collaborative group. Development of the QuickDASH: comparison of three item-reduction approaches","volume":"87","author":"Beaton","year":"2005","journal-title":"J Bone Joint Surg Am."},{"key":"R55-20250614","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol\u2014a new facility for the measurement of health-related quality of life","volume":"16","year":"1990","journal-title":"Health Policy."},{"key":"R56-20250614","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med Care."},{"key":"R57-20250614","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/01.blo.0000131484.27501.4b","article-title":"Locking compression plates for osteoporotic nonunions of the diaphyseal humerus","volume":"425","author":"Ring","year":"2004","journal-title":"Clin Orthop Relat Res."},{"key":"R58-20250614","first-page":"1442","article-title":"Plate fixation of ununited humeral shaft fractures: effect of type of bone graft on healing","volume":"88","author":"Hierholzer","year":"2006","journal-title":"J Bone Joint Surg Am."},{"key":"R59-20250614","first-page":"154","article-title":"Compression treatment of long bone pseudarthroses","volume":"138","author":"Rosen","year":"1979","journal-title":"Clin Orthop Relat Res."},{"key":"R60-20250614","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/jcb.240560303","article-title":"Mesenchymal stem cells in bone development, bone repair, and skeletal regenaration therapy","volume":"56","author":"Bruder","year":"1994","journal-title":"J Cel Biochem."},{"key":"R61-20250614","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00003086-199707000-00023","article-title":"Recalcitrant nonunion","volume":"340","author":"Ring","year":"1997","journal-title":"Clin Orthop Relat Res."},{"issue":"suppl 4","key":"R62-20250614","first-page":"S30","article-title":"Classification of non-union","volume":"36","author":"Megas","year":"2005","journal-title":"Injury."},{"key":"R63-20250614","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1053\/j.oto.2008.10.003","article-title":"Biomechanical strategies for managing atrophic and oligotrophic nonunions","volume":"18","author":"Tarkin","year":"2008","journal-title":"Oper Tech Orthop."},{"key":"R64-20250614","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00006534-200001000-00006","article-title":"Iliac crest bone graft harvesting techniques: a comparison","volume":"105","author":"Burstein","year":"2000","journal-title":"Plast Reconstr Surg."},{"key":"R65-20250614","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.injury.2011.03.045","article-title":"Judet decortication and compression plate fixation of long bone non-union: is bone graft necessary?","volume":"42","author":"Ramoutar","year":"2011","journal-title":"Injury."},{"key":"R66-20250614","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/BOT.0b013e31828b76f2","article-title":"A single-stage treatment protocol for presumptive aseptic diaphyseal nonunions: a review of outcomes","volume":"27","author":"Amorosa","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R67-20250614","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1302\/0301-620X.98B7.36061","article-title":"A unified theory of bone healing and nonunion","volume":"98B","author":"Elliott","year":"2016","journal-title":"Bone Joint J."},{"key":"R68-20250614","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.2106\/00004623-200211000-00001","article-title":"Expression and activation of the BMP-signaling components in human fracture nonunions","volume":"84","author":"Kloen","year":"2002","journal-title":"J Bone Joint Surg Am."},{"key":"R69-20250614","first-page":"83","article-title":"Treatment of nonunions by compression","volume":"43","author":"M\u00fcller","year":"1965","journal-title":"Clin Orthop Relat Res."},{"key":"R70-20250614","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/S1058-2746(98)90016-7","article-title":"Ununited humeral diaphyses","volume":"7","author":"Jupiter","year":"1998","journal-title":"J Shoulder Elbow Surg."},{"key":"R71-20250614","first-page":"20","article-title":"Osteogenic Protein-1 (Bone Morphogenic Protein-7) combined with various adjuncts in the treatment of humeral diaphyseal nonunions","volume":"63","author":"Bong","year":"2005","journal-title":"Bull NYU Hosp Joint Dis."},{"issue":"suppl 4","key":"R72-20250614","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1016\/j.injury.2005.10.010","article-title":"Application of recombinant BMP-7 on persistent upper and lower limb non-unions","volume":"36","author":"Dimitriou","year":"2005","journal-title":"Injury."},{"key":"R73-20250614","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00264-007-0422-x","article-title":"Clinical applications of BMP-7\/OP-1 in fractures, nonunions and spinal fusion","volume":"31","author":"White","year":"2007","journal-title":"Int Orthop."},{"key":"R74-20250614","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/BOT.0b013e31819b0bdc","article-title":"Proximal humeral nonunions treated with fixed-angle locked plating and an intramedullary strut allograft","volume":"23","author":"Badman","year":"2009","journal-title":"J Orthop Trauma."},{"key":"R75-20250614","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.injury.2010.04.002","article-title":"Management of nonunions of the proximal humeral diaphysis","volume":"41","author":"Prasarn","year":"2010","journal-title":"Injury."},{"key":"R76-20250614","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1097\/BOT.0b013e31825360fa","article-title":"Treatment of atrophic diaphyseal humeral nonunions with compressive locked plating and augmented with an intramedullary strut allograft","volume":"27","author":"Willis","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R77-20250614","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0020-1383(02)00381-9","article-title":"Delayed and non-union of the humeral diaphysis - compression plate or internal plate fixator?","volume":"35","author":"Wenzl","year":"2004","journal-title":"Injury."},{"key":"R78-20250614","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/BOT.0b013e318160c84c","article-title":"A mechanical comparison of the locking compression plate (LCP) and the low contact-dynamic compression plate (DCP) in an osteoporotic bone model","volume":"22","author":"Snow","year":"2008","journal-title":"J Orthop Trauma."},{"key":"R79-20250614","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s00590-012-1039-3","article-title":"Internal fixation of humeral shaft fractures using minimally invasive plating: comparative study of two implants","volume":"23","author":"Shen","year":"2013","journal-title":"Eur J Orthop Surg Traumatol."},{"key":"R80-20250614","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s10195-014-0290-2","article-title":"Plate osteosynthesis of fractures of the shaft of the humerus: comparison of limited contact dynamic compression plates and locking compression plates","volume":"15","author":"Singh","year":"2014","journal-title":"J Orthop Traumatol."},{"key":"R81-20250614","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11420-015-9453-9","article-title":"Initial surgical treatment of humeral shaft fracture predicts difficulty healing when humeral shaft nonunion cccurs","volume":"12","author":"Konda","year":"2016","journal-title":"HSS J."},{"issue":"suppl 4","key":"R82-20250614","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/S0020-1383(08)70003-2","article-title":"Fracture healing: the diamond concept","volume":"38","author":"Giannoudis","year":"2007","journal-title":"Injury."},{"key":"R83-20250614","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1302\/0301-620X.98B1.35682","article-title":"Treatment of nonunions in fractures of the humeral shaft according to the Diamond Concept","volume":"98B","author":"Miska","year":"2016","journal-title":"Bone Joint J."},{"key":"R84-20250614","doi-asserted-by":"crossref","first-page":"208","DOI":"10.2106\/00004623-200202000-00007","article-title":"The American Academy of Orthopaedic Surgeons outcomes instruments: normative values from the general population","volume":"84-A","author":"Hunsaker","year":"2002","journal-title":"J Bone Joint Surg Am."},{"key":"R85-20250614","doi-asserted-by":"crossref","first-page":"1074.e1","DOI":"10.1016\/j.jhsa.2005.04.009","article-title":"Measuring levels of upper-extremity disability in employed adults using the DASH questionnaire","volume":"30","author":"Jester","year":"2005","journal-title":"J Hand Surg Am."},{"key":"R86-20250614","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/1753193413481302","article-title":"The DASH and the QuickDASH instruments. Normative values in the general population in Norway","volume":"39","author":"Aasheim","year":"2014","journal-title":"J Hand Surg Eur Vol."},{"key":"R88-20250614","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/S0895-4356(98)00109-7","article-title":"Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project","volume":"51","author":"Gandek","year":"1998","journal-title":"J Clin Epidemiol."},{"key":"R89-20250614","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.injury.2009.09.023","article-title":"Prediction of outcome after humeral diaphyseal fracture","volume":"41","author":"Broadbent","year":"2010","journal-title":"Injury."},{"key":"R90-20250614","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.injury.2015.01.027","article-title":"Factors predicting patient-reported functional outcome scores after humeral shaft fractures","volume":"46","author":"Shields","year":"2015","journal-title":"Injury."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T19:04:11Z","timestamp":1749927851000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":86,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000002032","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8]]},"assertion":[{"value":"2020-12-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}