Distal humerus nonunion: evaluation and management

EFORT Open Reviews
Frédéric VauclairJoaquin Sanchez-Sotelo

Abstract

Despite recent improvements in surgical implants and techniques, distal humerus nonunion does occur between 8% and 25% of the time.Careful identification and improvement of any modifiable risk factors such as smoking, metabolic disorders, immunosuppressant medications, poor nutritional status and infection is mandatory.A recent computed tomography scan is paramount to determine the nonunion pattern, assess residual bone stock, identify previously placed hardware, and determine whether there is evidence of osteoarthritis or malunion of the articular surface.Internal fixation is the treatment of choice in the majority of patients presenting with reasonable bone stock and preserved articular cartilage; total elbow arthroplasty is an appealing alternative for elbows with severe destruction of the articular cartilage or severe bone loss at the articular segment, especially in older, female patients. Internal fixation requires not only achieving a stable fixation, but also releasing associated elbow contractures and the liberal use of bone graft or substitutes.Although reported union rates after internal fixation of distal humerus nonunions are excellent (over 95%), the complication rate remains very high, and unsatisfactory results ...Continue Reading

References

Jan 1, 1990·Journal of Orthopaedic Trauma·R A Sanders, J R Sackett
Sep 1, 1982·The Journal of Trauma·M M MitsunagaR L Linscheid
Feb 8, 2000·Clinical Orthopaedics and Related Research·S H Gallay, M D McKee
Dec 25, 2002·Journal of Orthopaedic Trauma·C Michael RobinsonCharles M Court-Brown
Jan 21, 2003·The Journal of Bone and Joint Surgery. American Volume·David L HelfetHoward S Rosen
Feb 15, 2003·The Journal of Bone and Joint Surgery. British Volume·R B SimonisA Khaleel
Apr 18, 2003·The Journal of the American Academy of Orthopaedic Surgeons·David M W Pugh, Michael D McKee
Jul 29, 2005·The Journal of Bone and Joint Surgery. British Volume·A AliD Stanley
Jan 21, 2006·Journal of Orthopaedic Trauma·David Ring, Jesse B Jupiter
Aug 30, 2008·International Orthopaedics·Christian Allende, Bartolomé T Allende
Sep 3, 2008·The Journal of Bone and Joint Surgery. American Volume·Akin CilBernard F Morrey
Nov 4, 2008·Journal of Orthopaedic Trauma·Jesse B Jupiter
Dec 24, 2010·Injury·Robert C SproulBrian T Feeley
Apr 8, 2011·The Journal of Bone and Joint Surgery. American Volume·Aaron NauthEmil H Schemitsch
Aug 16, 2011·Journal of Shoulder and Elbow Surgery·Yasser Ahmady Safoury, Mohamed Raffat Atteya
Feb 7, 2012·The Journal of Hand Surgery·Olukemi FajoluChristopher S Litts
Nov 12, 2013·The Journal of Hand Surgery·Alexis StuderGraham J W King
Oct 18, 2015·Journal of Shoulder and Elbow Surgery·Francesco PogliacomiRoberto Rotini
Sep 9, 2016·The Journal of Bone and Joint Surgery. American Volume·Michael B GottschalkJames Roberson

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Methods Mentioned

BETA
total elbow arthroplasty
dissection
biopsies

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