Dr. W. A. Mnaymneh: A 56-year-old man was admitted to the Massachusetts General Hospital with the diagnosis of nonunion of the left humeral shaft. His present illness dated back 2 1/2 years prior to admission, at which time he fell downstairs and sustained a fracture of the midshaft of the left humerus. He was admitted to another hospital in which open reduction and plating were done. The fracture did not heal. Three more open procedures were performed during the following 2 years. These included two iliac bone grafting procedures. Velpeau plaster casts were applied for periods ranging from 17 to 23 weeks. However, there was failure of healing after each procedure. Finally, the patient was given a sling to support his left arm.
When first seen at the MGH, this patient had gross motion, crepitus, and a mild degree of angulation at the fracture site. He had no pain. There