Srpski arhiv za celokupno lekarstvo 2018 Volume 146, Issue 3-4, Pages: 169-173
https://doi.org/10.2298/SARH170524140T
Full text ( 203 KB)
Distal humerus nonunions after failed internal fixation: Treatment with Ilizarov external fixator
Tomić Slavko (Institute for Orthopaedic Surgery “Banjica”, Belgrade)
Baljozović Andreja (Institute for Orthopaedic Surgery “Banjica”, Belgrade)
Introduction/Objective. Nonunions of distal humerus after unsuccessful
surgical treatment represents challenging surgical problem. The complexity of
this condition is increased by bone atrophy, scar tissue, poorly vascularized
bone fragment, limited elbow mobility, osteomyelitis and local neurological
damage. The advantages of using Ilizarov external fixation method are stable
fixation, adequate fracture reduction and fragment compression accompanied by
minimal soft tissue trauma, with the possibility of early elbow mobilization.
This aim of this paper is to present the treatment results of 19 patients
with nonunion of distal humerus after internal osteosynthesis managed by
Ilizarov external fixation method. Methods. nineteen consecutive patients
were treated with the Ilizarov external fixator. The study group includes 11
male and 8 female patients with an average age of 42 years. Surgical
technique consisted of approaching the nonunion, removing loose fixation
material, making resection and debridement of bone fragments, after which
Ilizarov fixator was placed. Rehabilitation of the elbow started in early
postoperative period. The functional status of the arm was evaluated using
the DASH score (Disabilities of the Arm, Shoulder and Head). Results. All
patients achieved solid bony union after average 7 months from application of
external fixator. In 17 patients radiographic analysis indicated the
preservation of joint space, while two showed degenerative changes. All
patients showed improvement in elbow range of motion and significantly better
DASH score with postoperative value of 21. Conclusion. As treatment of distal
humerus nonunion, Ilizarov external fixation method provides successful
healing and increased range of motion in the elbow.
Keywords: humerus, nonunion, Ilizarov technique