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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Bhashyam Abhiram R.; Jupiter Jesse B.

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Journal Paper

Paper Information

Journal: Archives of Bone and Joint Surgery Year:2019 | Volume:7 | Issue:3 Page(s): 251-257

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Information Journal Paper

Title

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?

Author(s)

Bhashyam Abhiram R. | Jupiter Jesse B. | Issue Writer Certificate

Keywords

Humeral fractures

Osteoporotic fractures

Ununited fracture

Abstract

Background: 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 frac-ture 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 Perfor-mance 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 flex-ion contracture of 32° . Average arthrosis grade was moderate joint-space narrowing with osteo-phyte formation. One patient had exertional discomfort but none required chronic pain medica-tions. 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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References

Open reduction and internal fixation for nonunion of extra-articular distal humeral fractures in patients 70 years and older

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APA: Copy

Bhashyam, Abhiram R., & Jupiter, Jesse B.. (2019). 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?. THE ARCHIVES OF BONE AND JOINT SURGERY, 7(3), 251-257. SID. https://sid.ir/paper/742104/en

Vancouver: Copy

Bhashyam Abhiram R., Jupiter Jesse B.. 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?. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2019;7(3):251-257. Available from: https://sid.ir/paper/742104/en

IEEE: Copy

Abhiram R. Bhashyam, and Jesse B. Jupiter, “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?,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 7, no. 3, pp. 251–257, 2019, [Online]. Available: https://sid.ir/paper/742104/en

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