TITLE

OPEN REDUCTION AND INTERNAL FIXATION OF DELAYED UNIONS AND NONUNIONS OF FRACTURES OF THE DISTAL PART OF THE HUMERUS

AUTHOR(S)
Helfet, David L.; Kloen, Peter; Anand, Neel; Rosen, Howard S.
PUB. DATE
January 2003
SOURCE
Journal of Bone & Joint Surgery, American Volume;Jan2003, Vol. 85-A Issue 1, p33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The purpose of the present retrospective study was to evaluate the results of open reduction and internal fixation of delayed unions and nonunions of fractures of the distal part of the humerus. Methods: Between 1976 and 2001, fifty-two patients with a delayed union (thirteen patients) or nonunion (thirty-nine patients) of the distal part of the humerus were treated with open reduction and internal fixation along with selective elbow joint arthrolysis and bone-grafting. The average time to presentation was eighteen months (range, two to 192 months) after the injury. Thirty-nine of the fifty-two patients had undergone an average of 1.6 previous operations. There were twenty-seven supracondylar, six transcondylar, thirteen intercondylar, two lateral condylar, and four medial condylar delayed unions or nonunions. The average duration of follow-up was thirty-three months (range, three to 198 months). Results: Fifty-one of the fifty-two patients had healing of the delayed union or nonunion after the index operation; the average time to union was six months (range, two to twenty-four months). The average range of elbow motion increased from 71° preoperatively to 94° postoperatively. Complications included two superficial infections, two deep infections, and five cases of ulnar neuropathy. Fifteen patients (29%) needed additional surgery after the index procedure. Specifically, seven patients underwent removal of prominent hardware; six underwent hardware removal along with excision of heterotopic bone, ulnar neurolysis, and/or manipulation under anesthesia; one underwent irrigation and débridement; and one underwent compartment release. Conclusions:Open reduction through an extensile exposure and rigid internal fixation consistently results in healing of a delayed union or nonunion of the distal part of the humerus. An improved range of motion of the elbow can be achieved by securing the site of the nonunion and performing aggressive elbow...
ACCESSION #
8797065

 

Related Articles

  • OPEN REDUCTION AND INTERNAL FIXATION OF HUMERAL NONUNIONS. Rubel, Iván F.; Kloen, Peter; Campbell, Deirdre; Schwartz, Mark; Liew, Alan; Myers, Elizabeth; Helfet, David L. // Journal of Bone & Joint Surgery, American Volume;Aug2002, Vol. 84-A Issue 8, p1315 

    Background: Several studies have compared different methods for fixation of the midpart of the humeral shaft, but there are only scattered data regarding which type of plate construct provides the best fixation for humeral nonunion. The objectives of this study were (1) to obtain objective data...

  • Open Reduction and Internal Fixation of Three and Four-Part Fractures of the Proximal Part of the Humerus. Wijgman, A.J.; Roolker, W.; Patt, T.W.; Raaymakers, E.L.F.B.; Marti, R.K. // Journal of Bone & Joint Surgery, American Volume;Nov2002, Vol. 84-A Issue 11, p1919 

    Background: Controversy persists concerning the preferred treatment of displaced fractures of the proximal part of the humerus. The present study was undertaken to evaluate the results of open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus...

  • Arthroscopic assisted removal of screws from proximal humeral locking plates. Dattani, Rupen; Patel, Vipul R. // International Journal of Shoulder Surgery;Jul-Sep2013, Vol. 7 Issue 3, p125 

    A letter to the editor is presented which describes a method for removal or exchange of prominent screws from proximal humeral locking plates during osteosynthesis.

  • Monoaxial versus polyaxial locking systems: a biomechanical analysis of different locking systems for the fixation of proximal humeral fractures. Zettl, Ralph; Müller, Thorben; Topp, Tobias; Lewan, Ulrike; Krüger, Antonio; Kühne, Christian; Ruchholtz, Steffen // International Orthopaedics;Aug2011, Vol. 35 Issue 8, p1245 

    Objective: The development of locking plate systems has led to polyaxial screws and new plate designs. This study compares monoaxial head locking screws (PHILOS© by Synthes) and a new generation of polyaxial locking screws (NCB-LE© by Zimmer) with respect to biomechanical stability....

  • Distal Humeral Fractures of the Adult. Werner, Clément; Ramseler, Leonhard; Trentz, Otmar; Heinzelmann, Michael // European Journal of Trauma;Jun2006, Vol. 32 Issue 3, p264 

    Purpose: Retrospective case series carried out to identify factors influencing the outcome of ORIF of distal humeral fractures in adults and to compare different elbow scoring systems. Patients and Methods: Twenty-eight consecutive distal humeral fractures sustained by 27 patients were treated...

  • Pourfour Du Petit syndrome after interscalene block. Santhosh, Mysore Chandramouli Basappji; Pai, Rohini B.; Rao, Raghavendra P. // Saudi Journal of Anaesthesia;Apr-Jun2013, Vol. 7 Issue 2, p203 

    Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner's syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that...

  • Fractures of the proximal humerus in osteoporotic bone. Hertel, Ralph // Osteoporosis International;May2005 Supplement 2, Vol. 16, pS65 

    The purpose of this article was to review critically the current treatment options for fractures of the proximal humerus in patients with severe osteoporosis. The main difficulties lie in correctly diagnosing the fracture and hence selecting the most appropriate method of treatment. The...

  • Distal humerus fractures in elderly patients: results after open reduction and internal fixation. Korner, Jan; Lill, Helmut; Müller, Lars Peter; Hessmann, Martin; Kopf, Klaus; Goldhahn, Jörg; Gonschorek, Oliver; Josten, Christoph; Rommens, Pol // Osteoporosis International;May2005 Supplement 2, Vol. 16, pS73 

    Problem: Fractures of the distal humerus are difficult to treat. In elderly patients, diminished bone mineral quality and increased trauma-associated joint destruction may make stable joint reconstruction even more problematic. Furthermore, comorbidities and poor tolerance of joint...

  • Minimal Invasive PHILOS®-Plate Osteosynthesis in Proximal Humeral Fractures. Acklin, Yves P.; Jenni, Raphael; Walliser, Martin; Sommer, Christoph // European Journal of Trauma & Emergency Surgery;Feb2009, Vol. 35 Issue 1, p35 

    The anterior delto-pectoral approach is the standard approach for the fixation of proximal humeral fractures with the PHILOS®-Plate system. However, this approach can impair the vascular supply and can increase avascular necrosis. The objective of this study was to evaluate the results and...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics