G Campochiaro1, P Baudi1, M Gialdini2, A Corradini1, V Duca1, M Rebuzzi3, F Catani1. 1. Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy. 2. Azienda Ospedaliero-Universitaria Policlinico di Modena, Via Largo del Pozzo 71/b, Modena, Italy. maurogialdini@gmail.com. 3. Arciospedale Santa Maria Nuova Reggio Emilia, viale risorgimento 80, Reggio Emilia, Italy.
Abstract
BACKGROUND: The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture. MATERIAL AND METHODS: From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle-proximal third and two in the middle third. In one case, a reverse shoulder prosthesis implant was associated to treat a co-existent rotator cuff massive lesion. The mean time between injury and treatment of non-union was 32 weeks (min 16-max 180); all patients were evaluated with Constant, DASH and UCLA score. RESULTS: At the final follow-up (23.7 months), the mean Dash score was 22.25 pt, the Constant score was 64 pt, and the UCLA score value was 27 pt. The average pain value was 2 for the arm interested and 0 into PSA focus. Radiographic healing was obtained at 7 months. CONCLUSIONS: The humeral shaft non-union is an invalidating problem which affects the daily living. Our treatment with plate, cortical bone graft, and PRP can build a high-stability structure that can help healing and graft integration.
BACKGROUND: The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture. MATERIAL AND METHODS: From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle-proximal third and two in the middle third. In one case, a reverse shoulder prosthesis implant was associated to treat a co-existent rotator cuff massive lesion. The mean time between injury and treatment of non-union was 32 weeks (min 16-max 180); all patients were evaluated with Constant, DASH and UCLA score. RESULTS: At the final follow-up (23.7 months), the mean Dash score was 22.25 pt, the Constant score was 64 pt, and the UCLA score value was 27 pt. The average pain value was 2 for the arm interested and 0 into PSA focus. Radiographic healing was obtained at 7 months. CONCLUSIONS: The humeral shaft non-union is an invalidating problem which affects the daily living. Our treatment with plate, cortical bone graft, and PRP can build a high-stability structure that can help healing and graft integration.
Authors: George M Kontakis; George M Papadokostakis; Kalliopi Alpantaki; Gregory Chlouverakis; Alexander G Hadjipavlou; Peter V Giannoudis Journal: Injury Date: 2006-06-14 Impact factor: 2.586
Authors: Franziska von der Helm; Annabel Fenwick; Jan Reuter; Leonard Adolf-Lisitano; Edgar Mayr; Stefan Förch Journal: Eur J Trauma Emerg Surg Date: 2021-12-31 Impact factor: 2.374