Open reduction and fixation with a locking plate without bone grafting is a reasonable and safe option for treating proximal humerus nonunion.

Autor: Quadlbauer, Stefan, Hofmann, Georg J., Leixnering, Martin, Rosenauer, Rudolf, Hausner, Thomas, Reichetseder, Jürgen
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Zdroj: International Orthopaedics; Sep2018, Vol. 42 Issue 9, p2199-2209, 11p
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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