Internal fixation combined with bone grafting for distal humeral nonunion
10.3760/cma.j.issn.1671-7600.2018.10.006
- VernacularTitle:内固定联合植骨治疗肱骨远端骨不连
- Author:
Yachao JIA
1
;
Jia XU
;
Chunyang WANG
;
Gen WEN
;
Pei HAN
;
Yimin CHAI
Author Information
1. 200233,上海交通大学附属第六人民医院骨科
- Keywords:
Humerus;
Fractures,ununited;
Fracture,fixation,internal;
Bone grafting
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(10):855-859
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the outcomes of internal fixation combined with bone grafting in the treatment of distal humeral nonunion.Methods This retrospective study included 48 patients who had undergone internal fixation combined with iliac bone grafting for distal humeral nonunion between January 2011 and December 2015 at Department of Orthopedic Surgery,The Sixth People's Hospital of Shanghai.They were 31 males and 17 females,with a mean age of 35.4 years (from 22 to 49 years).The outcomes were evaluated by clinical examination,X-ray film,Mayo elbow performance score (MEPS) and visual analogue scale (VAS) during follow-up.Results All the 48 patients were followed up for 18 to 60 months (mean,36 months).No wound-related complications were reported in this cohort.Solid bone union was achieved at 3 to 8 months (mean,4.2 months) after surgery.At the last follow-up,the range of elbow flexion-extension was improved from preoperative 66° to 101°,and the ranges of pronation and supination were enhanced from 65° and 45° preoperatively to 82° and 75°,respectively.The MEPS increased from 54 points preoperatively to 82 points postoperatively.The results were excellent in 26,good in 16 and fair in 6 cases (with an excellent to good rate of 87.5％).The VAS decreased from 4.5 points preoperatively to 1.2 points postoperatively,indicating notable relief of the elbow pain due to distal humeral nonunion.Follow-ups revealed no ulnar nerve injury,nonunion,heterotopic ossification,implant loosening or breakage,or instability of the elbow joint.Conclusion Internal fixation combined with bone grafting is reliable in treatment of distal humeral nonunion,leading to satisfactory outcomes.
