Stefan Quadlbauer1,2,3, Georg J Hofmann4, Martin Leixnering4, Rudolf Rosenauer4,5,6, Thomas Hausner4,5,6,7, Jürgen Reichetseder4. 1. AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria. stefan.quadlbauer@auva.at. 2. AUVA Research Center, Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, 1200, Vienna, Austria. stefan.quadlbauer@auva.at. 3. Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria. stefan.quadlbauer@auva.at. 4. AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria. 5. AUVA Research Center, Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, 1200, Vienna, Austria. 6. Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria. 7. Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University, 5020, Salzburg, Austria.
Abstract
AIM OF THE STUDY: The aim of this study was to evaluate union rate and clinical outcome in patients with proximal humeral nonunions treated by open reduction and locking plate fixation without bone grafting. METHODS: From 2011 to 2016, nine patients were treated using open reduction and locking plate stabilization without bone grafting. They were examined both clinically and radiologically, with a mean follow-up period of 31 months. Outcome was evaluated using pain and range of motion (ROM) parameters. In addition, self-assessment by patients was registered on the Disability of the Arm, Shoulder and Hand score, Constant-Murley Score, Oxford Shoulder Score, and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. A CT scan of the shoulder was performed to analyze union. RESULTS: At checkup, all patients showed union in the CT scans, where the mean ROM in abduction was 139° (SD 50°), in adduction 39° (SD 8°), in forward flexion 136° (SD 40°), in extension 44° (SD 11°), in internal rotation 62° (SD 15°), and external rotation 54° (SD 31°). ROM improved significantly in all planes of motion, except for adduction, post-surgery (p < 0.05). Plate removal was necessary in three patients. No complications were reported. CONCLUSION: Open reduction and locking plate fixation without bone grafting is a reasonable and safe option for treating proximal humerus nonunion. It leads to a high union rate, significant improvement in ROM, and in the majority of the cases to an "excellent" and "good" functional outcome without an increased risk of complications.
AIM OF THE STUDY: The aim of this study was to evaluate union rate and clinical outcome in patients with proximal humeral nonunions treated by open reduction and locking plate fixation without bone grafting. METHODS: From 2011 to 2016, nine patients were treated using open reduction and locking plate stabilization without bone grafting. They were examined both clinically and radiologically, with a mean follow-up period of 31 months. Outcome was evaluated using pain and range of motion (ROM) parameters. In addition, self-assessment by patients was registered on the Disability of the Arm, Shoulder and Hand score, Constant-Murley Score, Oxford Shoulder Score, and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. A CT scan of the shoulder was performed to analyze union. RESULTS: At checkup, all patients showed union in the CT scans, where the mean ROM in abduction was 139° (SD 50°), in adduction 39° (SD 8°), in forward flexion 136° (SD 40°), in extension 44° (SD 11°), in internal rotation 62° (SD 15°), and external rotation 54° (SD 31°). ROM improved significantly in all planes of motion, except for adduction, post-surgery (p < 0.05). Plate removal was necessary in three patients. No complications were reported. CONCLUSION: Open reduction and locking plate fixation without bone grafting is a reasonable and safe option for treating proximal humerus nonunion. It leads to a high union rate, significant improvement in ROM, and in the majority of the cases to an "excellent" and "good" functional outcome without an increased risk of complications.
Authors: Stefan Quadlbauer; Christoph Pezzei; Josef Jurkowitsch; Brigitta Kolmayr; Tina Keuchel; Daniel Simon; Thomas Hausner; Martin Leixnering Journal: J Wrist Surg Date: 2016-08-05
Authors: Thomas R Duquin; Justin A Jacobson; Joaquin Sanchez-Sotelo; John W Sperling; Robert H Cofield Journal: J Bone Joint Surg Am Date: 2012-09-05 Impact factor: 5.284
Authors: A Roux; L Decroocq; S El Batti; N Bonnevialle; G Moineau; C Trojani; P Boileau; F de Peretti Journal: Orthop Traumatol Surg Res Date: 2012-09-19 Impact factor: 2.256
Authors: N Südkamp; J Bayer; P Hepp; C Voigt; H Oestern; M Kääb; C Luo; M Plecko; K Wendt; W Köstler; G Konrad Journal: J Bone Joint Surg Am Date: 2009-06 Impact factor: 5.284