Abstract
INTRODUCTION: Long-standing non-unions of the humeral shaft with established pseudoarthrosis are rare and pose substantial challenges in management. This case report describes the successful treatment of such a patient. CASE REPORT: A 60-year-old male patient presented with a 40-year history of a humeral shaft fracture that had progressed to non-union with pseudoarthrosis. The patient underwent open reduction and internal fixation using a proximal humeral interlocking osteosynthesis system, augmented with an intramedullary fibular strut graft for added stability and an autogenous cancellous bone graft from the iliac crest to enhance healing. Post-operative radiological imaging confirmed successful bone healing, and the patient achieved a good range of motion in the affected arm. CONCLUSION: This case demonstrates that long-standing humeral shaft non-unions can achieve successful clinical outcomes when managed with mechanical stabilization and biological augmentation.