Peri-prosthetic humeral non-union: Where biology meets bio-mechanic. A case report

Ciurlia, Emanuele; Puddu, Leonardo; Caggiari, Gianfilippo; Andreozzi, Matteo; Doria, Carlo

doi:10.1016/j.ijscr.2017.08.001

Cited by 11 publications

(9 citation statements)

References 14 publications

(13 reference statements)

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“…40,[44][45][46] Two studies described the use of the parathyroid hormone derivative, teriparatide, to stimulate bone healing. 27,28 The third was revision arthroplasty using either a long stem to bypass the fracture, 35,37,[42][43][44]47 a revision stem with a strut allograft, 34,42 a humeral endoprosthesis, 37 a partial or total humeral prosthesis, 14,[37][38][39] or an allograft-prosthetic composite. 36,42 Functional outcomes were reported using the Constant Shoulder Score, 50 Oxford Shoulder Score (OSS), 51 Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), 52 Quick-DASH, 53 Simple Shoulder Test (SST), 54 American Shoulder and Elbow Surgeons standard shoulder assessment form (ASES), 55 Patient-Rated Elbow Evaluation score-Japanese (PREE-J), 56 Mayo Elbow Performance Score (MEPS), 57 Single Assessment Numeric Evaluation score (SANE), 58 and visual analogue pain scale (VAS).…”

Section: Resultsmentioning

confidence: 99%

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Management of periprosthetic fractures of the humerus

Mourkus

Phillips

Rangan

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to investigate the outcome of periprosthetic fractures of the humerus and to assess the uniformity of the classifications used for these fractures (including those around elbow and/or shoulder arthroplasties) by performing a systematic review of the literature. Methods A systematic search was conducted using the National Institute for Health and Care Excellence Healthcare Databases Advance Search. For inclusion, studies had to report clinical outcomes following the management of periprosthetic fractures of the humerus. The protocol was registered on the PROSPERO database. Results Overall, 40 studies were included, involving a total of 210 patients. The fractures were reported using very heterogeneous classification systems, as were the functional outcome scores. A total of 60 patients had nonoperative treatment with a 50% rate of nonunion. Fixation was undertaken in 99 patients; successful union was obtained in 93 (93%). Revision of either the humeral stem or the whole arthroplasty was reported in 79 patients with a high rate of union (n = 66; 84%), and a mean rate of complications of 29% (0% to 41%). Conclusion This study highlighted a lack of uniformity in classifying these fractures and reporting the outcome of their treatment. The results may help to inform decision-making with patients, particularly about the rate of complications of nonoperative treatment. There is a need to improve the reporting of the pattern of these fractures using a uniform classification system, and the harmonization of the collection of data relating to the outcome of treatment. Based on this review, we propose a minimum dataset to be used in future studies. Cite this article: Bone Joint J 2022;104-B(4):416–423.

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Section: Resultsmentioning

confidence: 99%

“…12 A total of 28 of these patients (47%) underwent surgery after a trial of nonoperative treatment for a mean period of 4.4 months (1.0 to 7.1). 13,26,28,36,42,[44][45][46][47] These methods are summarized in Table II.…”

Section: Revision Arthroplasty Surgical Fixation Nonoperativementioning

confidence: 99%

Management of periprosthetic fractures of the humerus

Mourkus

Phillips

Rangan

et al. 2022

The Bone & Joint Journal

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“…This type of procedure requires a biological response, but also adequate biomechanical support. 43 Regarding functional ability, all patients were able to adduce the thumb against both the second metacarpal than the distal phalanx of the 5 th metacarpus. All patients could lay their hands flat on the Table 1 ).…”

Section: Resultsmentioning

confidence: 91%

Suspension arthroplasty in the treatment of thumb carpometacarpal osteoarthritis

Caggiari¹,

Polese²,

Rosetti³

et al. 2021

Orthop Rev (Pavia)

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Literature presents several examples of surgical techniques for the treatment of carpometacarpal osteoarthritis. In our study we used a modified Ceruso’s suspended arthroplasty technique. In this study, 53 patients from 2011 to 2017 underwent arthroplasty with trapezius excision and suture suspension between abductor pollicis longus and flexor carpi radialis. The average age at surgery was 69, the participants were 43 women and 10 men. The average total operation time was 59 minutes. The modified CMC suspension arthroplasty technique provides excellent results compared with those in the literature.

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“…The evidence regarding the use of TPTD in fractures complicated by delayed union and non-union is limited to anecdotal reports. One such case report documented successful treatment of a peri-prosthetic humeral diaphysis non-union using internal fixation, augmented with massive bony autograft and post-operative treatment with 3 months of TPTD at a dose of 20 µg/day [76]. Similar reports have been published in other settings including, tibia/fibular, femur, ulna and type II odontoid fracture non-unions [69, 70, 77].…”

Section: Fracture Healingmentioning

confidence: 81%

Anabolic agents: what is beyond osteoporosis?

et al. 2018

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Osteoporosis is a common skeletal disorder characterized by low bone mass, which leads to reduced bone strength and an increased risk of fractures. Anabolic agents have been shown to improve bone mass and decrease fracture risk in osteoporosis patients by directly stimulating osteoblasts to produce new bone. Currently, two anabolic agents are available in the USA: recombinantly produced teriparatide (TPTD), which is the fully active (1-34) amino active sequence of human parathyroid hormone (PTH), and abaloparatide (APTD), a synthetic analog of parathyroid hormone-related peptide (PTHrP). At present, both agents are approved only for treatment of patients with osteoporosis at high risk of fracture. Nonetheless, their anabolic properties have led to off-label application in additional settings which include spine fusion, osteonecrosis of the jaw, arthroplasty, and fracture healing. In this article, we summarize available scientific literature regarding the efficacy, effectiveness, and safety of TPTD in these off-label settings.

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Peri-prosthetic humeral non-union: Where biology meets bio-mechanic. A case report

Cited by 11 publications

References 14 publications

Management of periprosthetic fractures of the humerus

Management of periprosthetic fractures of the humerus

Suspension arthroplasty in the treatment of thumb carpometacarpal osteoarthritis

Anabolic agents: what is beyond osteoporosis?

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