Acta Chir Orthop Traumatol Cech. 2022; 89(3):208-212 | DOI: 10.55095/achot2022/031

Treatment of the Refractory Atrophic Humeral Nonunion with Autogenous Block Iliac Crest Graft and Spongioplasty: a Retrospective StudyOriginal papers

G. OZDEMIR1, O. BINGOL1,*, F. INCI1, E. CEYHAN1, N. KARAHAN2, A. DEVECI3
1 Department of Orthopedic and Traumatology, Ankara City Hospital, Ankara, Turkey
2 Department of Orthopedic and Traumatology, Çorlu State Hospital, Tekirdağ, Turkey
3 Department of Orthopedic and Traumatology, Ankara Private Ortadoğu Hospital, Ankara, Turkey

PURPOSE OF THE STUDY:
Most humeral nonunions can be successfully treated with a single procedure, but some are more difficult to heal. Humeral nonunions which have two or more surgical procedures were defined as refractory humeral nonunions, and this condition is a very challenging condition. The aim of the study is to show the results of atrophic refractory humeral nonunion treated with open reduction and internal fixation and autogenous block iliac crest graft and spongioplasty.

MATERIAL AND METHODS:
Refractory humeral nonunions treated with open reduction and internal fixation and autogenous block iliac crest graft and spongioplasty from January 2010 to March 2019 were included this study retrospectively. Patient baseline information, number of previous surgeries, comorbidities, follow-up time, fracture union time, and complications were recorded. The functional outcome was evaluated with the Constant scores and Mayo scores at the end of the first year. The primary outcome variable was mentioned as bony union.

RESULTS:
A total of 13 refractory humeral nonunions included this study. The average age of the patients was 50.92±15.55 years (range, 26-78 years), and 8 of them were female. Preoperative and postoperative mean Mayo scores were; 56.54±17.84, and 85.38±7.49 respectively (p

Keywords: block graft, bone grafting, nonunion, refractory humeral nonunion, spongioplasty

Published: June 15, 2022  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
OZDEMIR G, BINGOL O, INCI F, CEYHAN E, KARAHAN N, DEVECI A. Treatment of the Refractory Atrophic Humeral Nonunion with Autogenous Block Iliac Crest Graft and Spongioplasty: a Retrospective Study. Acta Chir Orthop Traumatol Cech. 2022;89(3):208-212. doi: 10.55095/achot2022/031. PubMed PMID: 35815488.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Boer de HH, Wood MB, Hermans J. Reconstruction of large skeletal defects by vascularized fibula transfer. Int Orthop. 1990;14:121-128. Go to original source... Go to PubMed...
    2. Borus TA, Yian EH, Karunakar MA. A case series and review of salvage surgery for refractory humeral shaft nonunion following two or more prior surgical procedures. Iowa Orthop J. 2005;25:194-199. Go to PubMed...
    3. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin. Orthop Relat Res. 1987;214:160-164. Go to original source...
    4. Dhar S-A, Butt M-F, Dar T-A, Dar R-A, Ali Z. Management of humeral fracture nonunion in severe osteoporosis by a combination of locking plating and intramedullary fibular grafting. Chin J Traumatol. 2016;19:298-301. Go to original source... Go to PubMed...
    5. Gupta RC, Gaur SC, Tiwari RC, Varma B, Gupta R. Treatment of un-united fractures of the shaft of the humerus with bent nail. Injury. 1985;16:276-280. Go to original source... Go to PubMed...
    6. Healy WL, White GM, Mick CA, Brooker AFJ, Weiland AJ. Nonunion of the humeral shaft. Clin Orthop Relat Res. 1987;219:206-213. Go to original source...
    7. Hornicek FJ, Zych GA, Hutson JJ, Malinin TI. Salvage of humeral nonunions with onlay bone plate allograft augmentation. Clin Orthop Relat Res. 2001;386:203-209. Go to original source... Go to PubMed...
    8. Kurinomaru N, Zenke Y, Furukawa K, Yamanaka Y, Sakai A. Troubleshooting in the treatment of pseudoarthrosis after a humeral diaphyseal fracture: a case report. J UOEH. 2016;38:297-304. Go to original source... Go to PubMed...
    9. Látal P, Šperl J, Urban J, Štiková Z, Kloub M, Džupa V. Minimally invasive cancellous bone graft harvesting in trauma indication-clinical part of the study. Acta Chir Orthop Traumatol Cech. 2020;87:108-113. Go to original source... Go to PubMed...
    10. Marti RK, Verheyen CCPM, Besselaar PP. Humeral shaft nonunion: evaluation of uniform surgical repair in fifty-one patients. J Orthop Trauma. 2002;16:108-115. Go to original source... Go to PubMed...
    11. Martínez AA, Herrera A, Cuenca J. Good results with unreamed nail and bone grafting for humeral nonunion: a retrospective study of 21 patients. Acta Orthop Scand. 2002;73:273-276. Go to original source... Go to PubMed...
    12. Matityahu A, Eglseder WA Jr. Locking flexible nails for diaphyseal humeral fractures in the multiply injured patient: a preliminary study. Tech Hand Up Extrem Surg. 2011;15:172-176. Go to original source... Go to PubMed...
    13. Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am. 1992;74:479-490. Go to original source... Go to PubMed...
    14. Nauth A, Lee M, Gardner MJ, Brinker MR, Warner SJ, Tornetta P 3rd, Leucht P. Principles of nonunion management: state of the art. J Othop Trauma. 2018;32(Suppl 1):S52-S57. Go to original source... Go to PubMed...
    15. Neumann M v, Zwingmann J, Jaeger M, Hammer TO, Südkamp NP. Non-union in upper limb fractures-clinical evaluation and treatment options. Acta Chir Orthop Traumatol Cech. 2016;83:223-230. Go to original source... Go to PubMed...
    16. Patel VR, Menon DK, Pool RD, Simonis RB. Nonunion of the humerus after failure of surgical treatment. Management using the Ilizarov circular fixator. J Bone Joint Surg Br. 2000;82:977-983. Go to original source...
    17. Rosen H. The treatment of nonunions and pseudarthroses of the humeral shaft. Orthop Clin North Am. 1990;21:725-742. Go to original source... Go to PubMed...
    18. Rubel IF, Kloen P, Campbell D, Schwartz M, Liew A, Myers E, Helfet DL. Open reduction and internal fixation of humeral nonunions: a biomechanical and clinical study. J Bone Joint Surg Am. 2002;84:1315-1322. Go to original source... Go to PubMed...
    19. Tomić S, Bumbasirević M, Lesić A, Mitković M, Atkinson HDE. Ilizarov frame fixation without bone graft for atrophic humeral shaft nonunion: 28 patients with a minimum 2-year follow-up. J Orthop Trauma. 2007;21:549-556. Go to original source... Go to PubMed...
    20. Van Houwelingen AP, McKee MD. Treatment of osteopenic humeral shaft nonunion with compression plating, humeral cortical allograft struts, and bone grafting. J Orthop Trauma. 2005;19:36-42. Go to original source... Go to PubMed...

    Return to the content