Nonunion of distal humeral fractures: Current concepts.

Autor:	De Crescenzo A; Ente Ecclesiastico Ospedale 'F. Miulli', Ospedale 'F. Miulli', Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Acquaviva delle Fonti, Bari, Italy. Electronic address: dr.angelodecrescenzo@gmail.com., Garofalo R; Ente Ecclesiastico Ospedale 'F. Miulli', Ospedale 'F. Miulli', Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Acquaviva delle Fonti, Bari, Italy., Bartoli M; Humanitas Gavazzeni e Castelli, Department of Orthopaedic and Traumatology Surgery, Bergamo, Italy., Pederzini LA; Nuovo Ospedale di Sassuolo, Department of Orthopaedic, Traumatology and Arthroscopic surgeries, Modena Italy., Celli A; Hesperia Hospital, Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Modena, Italy.
Jazyk:	angličtina
Zdroj:	Journal of ISAKOS : joint disorders & orthopaedic sports medicine [J ISAKOS] 2024 Oct; Vol. 9 (5), pp. 100294. Date of Electronic Publication: 2024 Jul 19.
DOI:	10.1016/j.jisako.2024.07.002
Abstrakt:	The incidence of complex articular fractures of the distal humeral in adults has increased and will be growing in the future due to the greater incidence of high energy trauma and to the higher percentage of elderly population. Successful treatment is challenging for the needed balance between a stability of often comminuted fracture and early motion. Nonunion is a common complication after distal humerus fractures that is influenced by a variety of factors such as biology, in particular the blood supply of the metaphysis, the non-anatomical reduction of the fracture, the methods of fixation, and mechanical failure. These can involve the intra-articular or extra-articular areas. Clinical presentation may be mainly with a flail elbow in extra-articular nonunion or mainly with disfunction and stiffness for an intra-articular nonunion. However, the symptoms will depend on the degree of articular surfaces damage and the main localization of nonunion in the intra- and extra-articular region. The surgical treatment is usually required, being the non-operative treatment with a brace a reasonable option just for low-demand patients and with a high risk of complications. Despite a limited range of motion regained, the union rate achieved with internal fixation and bone grafting is substantially high. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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