medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2003, Number 2

<< Back Next >>

Acta Ortop Mex 2003; 17 (2)

Total humerus substitution. A case report

Tokunaga BJJ, Salazar PR, González OS

Language: Spanish
References: 14
Page: 101-104
PDF size: 102.95 Kb.


ABSTRACT

It is reported a case of a male 46 old years patient suffering from a multifragmentary humerus diaphysis fracture, classified as 12 B2.3 according to AO classification, presenting radial nerve neuromesis. During four years this was managed through different treatments, tubular external fixer in 3 occasions, DCP plaque, loose grafting, vascular grafting, obtaining the diaphysis reabsorption, non-union, grafting preabsorption and glenoid-humeral joint stiffness. Because of this, it was decided to perform a complete replacement by a total humerus prosthesis, succeeding in preserving the extremity, even though mobility became restricted (40° abduction, 30° extension, 30° flexion, 60° elbow flexion). It is considered that this procedure is indicated in extremely rare cases when the alternative of disarticulation is set up as probable.


REFERENCES

  1. Chapman J, Weber TG: Randomized prospective study of humerus fixation: Nails vs Plates: Presented at the Annual Meeting of the Orthopaedic Trauma Association, Tampa, Fla, September 30, 1995.

  2. Dabezies EJ, Banta CJ: Plate fixation of the humeral shaft for acute fractures, with and without radial nerve injuries. J Orthop Trauma 1992; 6: 10-3.

  3. Foster R, et al: Internal fixation of fractures and nonunion of the humeral shaft; Indications and results in a multi-center study. J Bone Joint Surg Am 1985; 67: 857-64.

  4. Gazdag AR, Lane JM, et al: Alternatives to Autogenous Bone Graft: Efficacy and indications. J Am Acad Orthop Surg 1995; 3: 1-8.

  5. Helm D, Et al: Surgical treatment of humeral shaft fractures. The basel experience. J Trauma 1993; 35: 226-32.

  6. Mc Kee M, Jupiter J, Toh CL, et al: Reconstruction after malunion and nonunion of intra-articular fractures of the distal humerus. J Bone Joint Surg 1994; 76B: 614-21.

  7. Müller ME, Allgöwer M: Manual de Osteosíntesis. 3ra edición, Springer-verlag Ibérica, 1992.

  8. Ring D, et al: Atrophic ununited diaphyseal fractures of the humerus with a bony defect. J Bone Joint Surg 2000; 82(6): 867-871.

  9. Rodríguez-Merchán EC: Compression plating versus Hackethal nailing in closed humeral shaft fractures failing nonoperative reduction. J Orthop Trauma 1995; 9: 194-7.

  10. Rosen Howard: Nonunion and malunion. Skeletal trauma. Browner Bruce. Saunders Company, CD-rom version. 1998.

  11. Rosen H: The treatment of nonunions and pseudarthroses of the humerus shaft. Orthop Clin North Am 1990; 21: 725.

  12. Schatzker J, TileI M: Tratamiento quirúrgico de las fracturas. Primera edición, Panamericana, Argentina 1994: 84-96.

  13. Uhthoff HK, Jaworski ZFG: Bone loss in response to long-term immobilization. J Bone Joint Surg Br 1978; 60: 420-9.

  14. Watanabe RS: Intramedullary fixation of complicated fractures of the humeral shaft. Clin Orthop 1993; 292: 255-263.




2020     |     www.medigraphic.com