Humeral shaft non-union after intramedullary nailing

被引：9
作者：
Campochiaro G. [1 ]
Baudi P. [1 ]
Gialdini M. [1 ]
Corradini A. [1 ]
Duca V. [1 ]
Rebuzzi M. [2 ]
Catani F. [1 ]
机构：
[1] Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena
[2] Arciospedale Santa Maria Nuova Reggio Emilia, viale risorgimento 80, Reggio Emilia
来源：
MUSCULOSKELETAL SURGERY | 2017年 / 101卷 / 2期
关键词：
Humerus; Nailing; Non-union; Plate;
D O I：
10.1007/s12306-017-0468-x
中图分类号：
学科分类号：
摘要：
Background: The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture. Material and Methods: From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle–proximal third and two in the middle third. In one case, a reverse shoulder prosthesis implant was associated to treat a co-existent rotator cuff massive lesion. The mean time between injury and treatment of non-union was 32 weeks (min 16–max 180); all patients were evaluated with Constant, DASH and UCLA score. Results: At the final follow-up (23.7 months), the mean Dash score was 22.25 pt, the Constant score was 64 pt, and the UCLA score value was 27 pt. The average pain value was 2 for the arm interested and 0 into PSA focus. Radiographic healing was obtained at 7 months. Conclusions: The humeral shaft non-union is an invalidating problem which affects the daily living. Our treatment with plate, cortical bone graft, and PRP can build a high-stability structure that can help healing and graft integration. © 2017, Istituto Ortopedico Rizzoli.
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页码：189 / 193
页数：4
相关论文
共 20 条
  • [1] Muller M.E., Nazarian S., Classification of fractures of the femur and its use in the A.O, Rev Chir Orthop Reparatrice Appar Mot, 67, 3, pp. 297-309, (1981)
  • [2] Constant C.R., Murley A.H., A clinical method of functional assessment of the shoulder, Clin Orthop, 214, pp. 160-164, (1987)
  • [3] Hudak P.L., Amadio P.C., Bombardier C., Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG), Am J Ind Med, 29, 6, pp. 602-608, (1996)
  • [4] Amstutz H.C., Sew Hoy A.L., Clarke I.C., UCLA anatomic total shoulder arthroplasty, Clin Orthop, 155, pp. 7-20, (1981)
  • [5] King G.J., Richards R.R., Zuckerman J.D., Blasier R., Dillman C., Friedman R.J., Et al., A standardized method for assessment of elbow function. Research Committee, American Shoulder and Elbow Surgeons, J Shoulder Elbow Surg, 8, 4, pp. 351-354, (1999)
  • [6] de Bernard Dompsure R., Peter R., Hoffmeyer P., Uninfected nonunion of the humeral diaphyses: review of 21 patients treated with shingling, compression plate, and autologous bone graft, Orthop Traumatol Surg Res OTSR, 96, 2, pp. 139-146, (2010)
  • [7] Jupiter J.B., von Deck M., Ununited humeral diaphyses, J Shoulder Elbow Surg, 7, 6, pp. 644-653, (1998)
  • [8] Giannoudis P.V., Einhorn T.A., Marsh D., Fracture healing: the diamond concept, Injury, 38, pp. S3-S6, (2007)
  • [9] Sarmiento A., Zagorski J.B., Zych G.A., Latta L.L., Capps C.A., Functional bracing for the treatment of fractures of the humeral diaphysis, J Bone Jt Surg Am, 82, 4, pp. 478-486, (2000)
  • [10] Marti R.K., Verheyen C.C.P.M., Besselaar P.P., Humeral shaft nonunion: evaluation of uniform surgical repair in fifty-one patients, J Orthop Trauma [Internet], 16, 2, (2002)
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