فایل (word) مقاله Revision fixation of distal humerus fracture nonunions in older age patients with poor bone quality or bone loss – is this viable as a long-term treatment option?

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بخشی از متن فایل (word) مقاله Revision fixation of distal humerus fracture nonunions in older age patients with poor bone quality or bone loss – is this viable as a long-term treatment option? :


تعداد صفحات :11

Objective The purpose of this retrospective study was to analyze the long-term results of revision ORIF, joint contracture release, and autogenous bone-grafting in the treatment of distal humerus fracture nonunions in older aged patients with poor bone quality or bone loss who would have been candidates for total elbow arthroplasty. Methods Seven patients (average age at index procedure: 53.3 years, range: 41-75) with a distal humerus fracture nonunion treated with revision ORIF, joint contracture release and autogenous bone grafting between 1989-2000 were available for follow-up. Radiographic union and arthrosis were assessed using the most recent radiograph. Pain-related outcomes were measured using PROMIS Pain Interference scores. Functional outcomes were evaluated using the Mayo Elbow Performance Index (MEPI). Results After an average follow-up of 22 years (range: 19-27 years), all nonunions were healed after the index procedure and had an average arc of ulnohumeral motion of 80°, flexion of 112°, and flexion contracture of 32°. Average arthrosis grade was moderate joint-space narrowing with osteophyte formation. One patient had exertional discomfort but none required chronic pain medications. PROMIS-Pain Interference scores were no different than the general population (mean [95%CI] = 49.2 [41.8, 56.6], p=0.83). Per the MEPI, the functional result was excellent in five patients, good in one, and poor in one. Conclusion Despite older age and worse bone quality, distal humerus fracture nonunions can be treated using revision ORIF, joint contracture release and autogenous bone-grafting with acceptable long-term outcomes.

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