Jae Sung Lee; Soo Yong Kang; Jae Hyun Yoo

doi:10.12671/jkfs.2008.21.1.45

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Original Article
Nonunion with a Bony Defect of the Humerus: Treatment by Shortening: Jae Sung Lee, M.D., Soo Yong Kang, M.D., Jae Hyun Yoo, M.D.; Journal of the Korean Fracture Society 2008;21(1):45-50.
DOI: https://doi.org/10.12671/jkfs.2008.21.1.45
Published online: January 31, 2008

Department of Orthopaedic Surgery, Yong-San Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Address reprint requests to: Soo Yong Kang, M.D. Department of Orthopaedic Surgury, Chung-Ang University Yongsan Hospital, 65-207, Hangangno 3-ga, Yongsan-gu, Seoul 140-757, Korea. Tel: 82-2-748-9848, Fax: 82-2-793-6634, sooykang@hitel.net

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To evaluate clinical results and advantage of interposition and shortening technique for the treatment of the humeral nonunion with bone defect.
Materials and Methods
Eight patients with the humeral nonunion with bone defect underwent interposition of fragments and shortening had been followed-up for more than one year (mean 70 months, 16~156). There were 4 men and 4 women with a mean age of 60.5 years (range, 48 to 75 years). There included 3 proximal, 3 diaphysis and 2 distal metaphysis according to the site, mean size of the bone defect was 3.3 cm (2~5). The time to union, discrepancy of upper extremity, functional results, cosmetic satisfaction and postoperative complications were assessed.
Results
All patients achieved to bone union, average union time was 10.2 weeks (range 8~14). Average limb discrepancy was 2.3 cm. All had improvement in shoulder and elbow motion after operation. Seven patients were satisfied with the cosmetic result and none had functional deficit due to limb discrepancy.
Conclusion
Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.
Key words: Humerus, Nonunion, Bony defect, Shortening

REFERENCES

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6. Perren SM. The concept of biological plating using the limited contact-dynamic compression plate (LC-DCP). Scientific background, design and application. Injury, 1991;22:Suppl 1. 1-41.
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9. Ring D, Jupiter JB, Quintero J, Sanders RA, Marti RK. Atrophic ununited diaphyseal fractures of the humerus with a bony defect: treatment by wave-plate osteosynthesis. J Bone Joint Surg Br, 2000;82:867-871.
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Fig. 1

Schematic illustration of the shortening and interposition technique.

Fig. 2

50-year-old woman presented with pain and motion limitation of left elbow.

(A) Preoperative radiograph shows nonunion with 5 cm bone defect of supracondylar area of the humerus.

(B) Postoperative radiograph shows interposition of the distal fragment to the proximal fragment and external fixation.

(C) 12 months after operation, bone union was achieved.

(D) The arc of ulnohumeral motion was checked 20 to 110 degree and limb discrepancy was checked 4.5 cm.

Fig. 3

75 year-old male presented with pain and weakness of right arm after opearative fixation of a fracture of the distal shaft of the humerus.

(A) Anteroposterior radiograph demonstrating nonunion with bony defect and screw loosening.

(B) The preoperative plan.

(C) 2 months after a wave plate and autogenous bone graft had been applied, bone union was achieved and the limb discrepancy wad checked 2 cm.

Table 1

Data on eight patients with a nonunion of the humerus with a bone defect

Figure & Data

REFERENCES

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Nonunion with a Bony Defect of the Humerus: Treatment by Shortening

J Korean Fract Soc. 2008;21(1):45-50. Published online January 31, 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.1.45

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Figure

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Nonunion with a Bony Defect of the Humerus: Treatment by Shortening

Fig. 1 Schematic illustration of the shortening and interposition technique.

Fig. 2 50-year-old woman presented with pain and motion limitation of left elbow. (A) Preoperative radiograph shows nonunion with 5 cm bone defect of supracondylar area of the humerus. (B) Postoperative radiograph shows interposition of the distal fragment to the proximal fragment and external fixation. (C) 12 months after operation, bone union was achieved. (D) The arc of ulnohumeral motion was checked 20 to 110 degree and limb discrepancy was checked 4.5 cm.

Fig. 3 75 year-old male presented with pain and weakness of right arm after opearative fixation of a fracture of the distal shaft of the humerus. (A) Anteroposterior radiograph demonstrating nonunion with bony defect and screw loosening. (B) The preoperative plan. (C) 2 months after a wave plate and autogenous bone graft had been applied, bone union was achieved and the limb discrepancy wad checked 2 cm.

Fig. 1

Fig. 2

Fig. 3

Nonunion with a Bony Defect of the Humerus: Treatment by Shortening

Table 1

Data on eight patients with a nonunion of the humerus with a bone defect

Table 1 Data on eight patients with a nonunion of the humerus with a bone defect