Three-stage treatment protocol for recalcitrant distal femoral nonunion

Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan‐Kun; Yen, Cheng-Yo; Wu, Cheng‐Hsien

doi:10.1007/s00402-017-2634-x

Cited by 18 publications

(16 citation statements)

References 25 publications

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“…This was a retrospective study of the medical records and radiographs of 15 consecutive patients who underwent an intervention for aseptic recalcitrant humeral shaft nonunion between May 2010 and August 2017 in the department of orthopedic trauma, Honghui Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China (Table 1 ). The inclusion criteria were: 1) patients who received one or more surgical revisions for nonunion of the humeral shaft at least 9 months ago, and the fracture had shown no visible progressive signs of healing for 3 months [ 14 ]; 2) pain and dysfunction requiring intervention; 3) a revision procedure comprising double plate fixation in combination with autogenous iliac crest bone grafting. The exclusion criteria were single plate fixation, internal nailing, external fixation, or infected nonunion.…”

Section: Methodsmentioning

confidence: 99%

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Feng

Wang

Sun

et al. 2020

BMC Musculoskelet Disord

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Background Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion. Methods A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented. Results The study cohort comprised six females and nine males with a mean age of 45.3 ± 13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8 ± 124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest. Conclusion Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.

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Section: Methodsmentioning

confidence: 99%

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Feng

Wang

Sun

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…This was a retrospective study of the medical records and radiographs of 15 consecutive patients who underwent an intervention for aseptic recalcitrant humeral shaft nonunion between May 2010 and August 2017 in the department of orthopedic trauma, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China (Table 1). The inclusion criteria were: 1) patients who received one or more surgical revisions for nonunion of the humeral shaft at least 9 months ago, and the fracture had shown no visible progressive signs of healing for 3 months [14]; 2) pain and dysfunction requiring intervention; 3) a revision procedure comprising double plate xation in combination with autogenous iliac crest bone grafting. The exclusion criteria were single plate xation, internal nailing, external xation, or infected nonunion.…”

Section: Methodsmentioning

confidence: 99%

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Feng¹,

Wang²,

Sun³

et al. 2021

Preprint

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Background: Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion.Methods: A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented.Results: The study cohort comprised six females and nine males with a mean age of 45.3±13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8±124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest.Conclusion: Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.

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“…This study was approved by the Ethics Committee of Hong Hui Hospital, Xi' an Jiaotong University. The inclusion criteria were follow: 1) skeletally mature (18-85 years) patients satis ed diagnosis of recalcitrant nonunion, which was a patient had already received surgical revision at least once for nonunion, and a minimum of 9 months has elapsed since last treatment and the fracture shows no visibly progressive signs of healing for 3 months [13]; 2) patients suffered pain and weakness in the upper limb need intervention; 3) patients with a revision procedure of double plate xation in combination with autogenous iliac crest bone grafting.…”

Section: Methodsmentioning

confidence: 99%

Double Plating With Autogenous Bone Grafting as a Salvage Procedure for Recalcitrant Humeral Shaft Nonunion

Feng¹,

Wang²,

Sun³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Despite the majority humeral shaft nonunions respond well to surgical intervention, a surgeon still encounters a patient with humeral shaft nonunion who had already undergone repeated surgeries for nonunion. This study is a retrospective analysis of the efficacy of the treatment of recalcitrant humeral shaft nonunions using double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting.Methods: A consecutive series of aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in the authors’ institute. Standardized treatment included a thorough debridement, double LCP and screw fixation, and autogenous iliac bone graft. The injury type, the bone affected by nonunion, and the duration of nonunion were recorded for all patients. The main outcome measurements were Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function and the visual analog scale (VAS) for pain. In addition, all complications were documented.Results: The study consisted of six females and nine males with a mean age of 45.3±13.1 years. Each patient had already undergone at least once failed surgical management for nonunion. The average duration that the bone remained ununited before the index intervention was 126.8±124.2 months. All patients achieved bone union without implant failure. At the final follow-up, both the mean Constant and Murley joint function score and the mean MEPI were significantly improved, and the mean VAS score significantly decreased. Each patient was highly satisfied with the treatment. Complications were only seen in four patents, including one super wound infection, one radial nerve palsy, one ulnar never palsy, and one discomfort at the iliac crest.Conclusion: Double plate fixation combined with autogenous iliac crest bone grafting can result in successful salvage of humerus nonunions in patients who have failed prior surgical interventions.

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Three-stage treatment protocol for recalcitrant distal femoral nonunion

Abstract: Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

Cited by 18 publications

References 25 publications

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

Double Plating With Autogenous Bone Grafting as a Salvage Procedure for Recalcitrant Humeral Shaft Nonunion

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