SciELO - Scientific Electronic Library Online

 
vol.37 número2¿Qué tan común es la deformidad extraarticular de rodilla? ¿Cómo lograr una artroplastia total de rodilla con alineación de «zona segura» en pacientes con deformidad extraarticular?¿Cuándo se reanuda la conducción después del reemplazo total de cadera primario? índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

Links relacionados

  • No hay artículos similaresSimilares en SciELO

Compartir


Acta ortopédica mexicana

versión impresa ISSN 2306-4102

Resumen

PAZ, ML; GUTIERREZ, N; DIAZ, M  y  ALLENDE, C. Diaphyseal osteoporotic nonunion of the humerus in elderly patients. Surgical treatment and long-term results. Acta ortop. mex [online]. 2023, vol.37, n.2, pp.85-93.  Epub 06-Mayo-2024. ISSN 2306-4102.  https://doi.org/10.35366/112987.

Introduction:

to evaluate the long term radiographic and functional results achieved in adult patients with osteoporotic, atrophic, non-unions of the diaphyseal humerus, treated surgically by open reduction and internal fixation with plates and bone graft.

Material and methods:

we retrospectively evaluated 22 patients. Patient’s age averaged 72 years. Time from initial trauma to definitive surgery averaged 18 months. Eleven patients were smokers, and four had active infection. Pre-operative Constant score and DASH score averaged 23.13 and 81.04, respectively. Pre-operative pain scale averaged 7.45 points.

Results:

follow-up averaged 69 months. Union was achieved in all cases after an average of 4.68 months. DASH score at last follow-up averaged 20.27 points and Constant score 79.31 points. Analog pain scale averaged 0.77 points. Stabilization was performed using locking blade plates in 12 non-unions, locking compression plates in six cases, and double plating in four non-unions. Patients with active infection were treated in two stages using Masquelet’s technique. Bone graft was associated in all cases (cancellous iliac crest autograft in 17, allograft in three, and combined structural allograft and cancellous autograft in two). Two grams of vancomycin powder were associated to the bone graft in all cases.

Conclusion:

the use of open reduction and internal fixation with plates associated to bone graft with local antibiotics, aloud achieving bony union and good predictable long-term objective and subjective functional results in all cases, without major complications or the need of further surgical intervention.

Palabras llave : non-union; humerus; diaphyseal; osteoporosis.

        · resumen en Español     · texto en Español     · Español ( pdf )