J Reconstr Microsurg 2009; 25(2): 117-124
DOI: 10.1055/s-0028-1090624
© Thieme Medical Publishers

Treatment of Chronic Nonunions of the Humerus with Free Vascularized Fibula Transfer: A Report of Thirteen Cases

A. Bobby Chhabra1 , 2 , S. Raymond Golish1 , 2 , Michael E. Pannunzio3 , Thomas E. Butler4  Jr. , Luis E. Bolano5 , William C. Pederson6
  • 1Department of Orthopaedics, University of Virginia, Charlottesville, Virginia
  • 2University of Virginia Hand Center, Charlottesville, Virginia
  • 3Reconstructive Hand Surgeons of Indiana, Carmel, Indiana
  • 4Southwest Shoulder and Elbow Surgery, Tucson, Arizona
  • 5Scott Orthopaedic Center, Huntigton, West Virginia, San Antonio, Texas
  • 6Hand Center of San Antonio, San Antonio, Texas
Further Information

Publication History

Publication Date:
16 October 2008 (online)


Chronic nonunions of the humerus remain a challenging problem. We reviewed 13 cases of chronic nonunion of the humerus resulting from trauma or osteomyelitis treated with vascularized fibula transfer after failure of conventional treatment. Patient averages were 35 years of age, follow-up of 19 months, and 4.2 prior operations. Healing was obtained in 12 of 13 (92%) patients with an average healing time of 18 weeks and graft length of 12.5 cm. In total, 11 of 12 (91%) patients who united had good to excellent range of motion of their shoulder and elbow. There were eight complications in 7 of 13 patients (54%). Two patients developed fractures of the graft, and three had superficial infections at the harvest site requiring operative debridement. Two patients had median neurapraxia that resolved by 4 months. Two patients complained of intermittent pain at the donor site. No significant correlations were found between time to heal and other covariates.


A. Bobby Chhabra, M.D. 

Department of Orthopaedic Surgery, University of Virginia Health System

Box 800159, Charlottesville, VA 22908

Email: ac2h@virginia.edu