scholarly journals Radiation-Associated Fracture Nonunion of the Clavicle Treated with Locking Plate Fixation and Autologous Bone Grafting

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Takahiro Niikura ◽  
Sang Yang Lee ◽  
Yoshitada Sakai ◽  
Kotaro Nishida ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Locking Plate ◽  
Plate Fixation ◽  
Fluid Collection ◽  
Bony Union ◽  
Locking Plate Fixation ◽  
Autologous Bone Grafting ◽  
Fracture Nonunion ◽  
Autologous Bone ◽  
The Right

We describe a case of radiation-associated fracture nonunion of the clavicle, which was treated by locking plate fixation and autologous bone grafting. The patient was a 67-year old man who received 70 Gy radiation therapy to treat nasopharyngeal carcinoma. Eight years later, he suffered a pathological fracture of the right clavicle. One year after the fracture, surgical treatment was performed due to persistent pain and weakness. Radiographs demonstrated atrophic nonunion. Bone scan demonstrated hot uptake at both ends of the fractured bone. MRI demonstrated a formation of pseudoarthrosis with fluid collection and suggested bone marrow edema at both ends of the fracture fragments. In surgery, fibrous pseudoarthrosis tissue was excised and both ends of the fracture fragments were refreshed to identify bleeding. Open reduction and internal fixation using a 7-hole locking plate and autologous bone grafting were performed. Successful bony union was obtained 1 year postoperatively, and no adverse events were observed up to 52 months after the operation. Our case suggests that a locking plate provides sufficient fixation and autologous bone grafting is effective in enhancing bone healing in a radiation-associated fracture nonunion of the clavicle in which it is difficult to achieve bony union.

scholarly journals Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Genta Fukumoto ◽  
Tomoaki Fukui ◽  
Keisuke Oe ◽  
Atsuyuki Inui ◽  
Yutaka Mifune ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Bone Grafting ◽  
Full Range ◽  
Biologically Active ◽  
Humeral Shaft ◽  
Bony Union ◽  
Autologous Bone Grafting ◽  
Humeral Shaft Nonunion ◽  
Autologous Bone ◽  
Compression Plating

Introduction. Although the recommended treatment for humeral shaft nonunion is compression plating with autologous bone grafting, we treated a case of humeral shaft nonunion with an intramedullary nail (IMN) without bone grafting. Presentation of Case. Osteosynthesis with IMN was performed on a 24-year-old man with a humeral shaft fracture at another hospital. However, bony union was not obtained 1 year after the first surgery, and he was referred to our institution. We treated the nonunion with exchange nailing without autologous bone grafting using compression function of the nail, leading to bony union at 7 months postoperatively. At the final follow-up 2 years and 4 months postoperatively, the patient had full range of motion in the left shoulder and elbow joints. Discussion. Compression plating with autologous bone grafting is reported to be the gold standard for the treatment of humeral shaft nonunion. IMN is advantageous for minimal invasion; however, the conventional type of IMN cannot apply compression force between fragments and does not have sufficient stability against rotational force. In this case, we used an IMN that could apply compression between the fragments and which had rotational stability via many screws. We did not perform bone grafting because the current nonunion was adjudged to be biologically active, and we achieved good functional results. Conclusion. We treated humeral shaft nonunion using IMN with compression, but without bone grafting, leading to successful clinical outcomes. This strategy might be an appropriate choice for the treatment of humeral shaft nonunion with biological activity.

Clinical outcomes of unstable metacarpal and phalangeal fractures treated with a locking plate system: a prospective study

2020 ◽  
Vol 45 (6) ◽  
pp. 582-587
Author(s):  
Takeshi Katayama ◽  
Kazuhiko Furuta ◽  
Hiroshi Ono ◽  
Shohei Omokawa
Keyword(s):  
Clinical Outcomes ◽  
Locking Plate ◽  
Plate Fixation ◽  
Bony Union ◽  
Complication Rates ◽  
Locking Plate Fixation ◽  
Level Of Evidence ◽  
Finger Motion ◽  
Phalangeal Fractures

We prospectively assessed clinical and radiological outcomes of locking plate fixation in treating unstable fractures in 11 metacarpals, 15 proximal phalanges, and eight middle phalanges in 34 consecutive patients from October 2011 to December 2016. Median length of follow-up was 14 months (range 12–24). The motion of finger joints, bony union, and complication rates were recorded. The median postoperative range of motion of the two interphalangeal joints and the metacarpophalangeal joint was 82% of the contralateral hands. Fractures in the three locations had significantly different recovery of the finger motion, with the best recovery for the metacarpal fractures. Closer distance between the plate edge and joint line was associated with a more limited range of the finger motion. The clinical outcomes approached an acceptable level at final follow-up. Finger stiffness is unavoidable after locking plate fixation of metacarpal and phalangeal fractures even with early hand therapy, with stiffness occurring in 10 out of 34 cases at the time of final follow-up 1 year after surgery. Level of evidence: II

Bone Autograft Coupled with Locking Plates Repairs Symptomatic Rib Fracture Nonunions

2018 ◽  
Vol 84 (6) ◽  
pp. 844-850
Author(s):  
Matthew C. Hernandez ◽  
Janani S. Reisenauer ◽  
Johnathon M. Aho ◽  
Muhammad Zeb ◽  
Cornelius A. Thiels ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Rare Complication ◽  
Plate Fixation ◽  
Rib Fracture ◽  
Autologous Bone Grafting ◽  
Rib Fixation ◽  
Patient Reported ◽  
Autologous Bone ◽  
Bone Autograft

Symptomatic rib nonunions are a rare complication after rib fractures. Methods used to address these nonunions range from pain management, rib resection, and rib fixation with plates and occasional autologous bone grafting. Given potential complications associated with rib resections such as pulmonary hernia, we hypothesized that plate fixation and autologous bone grafting would yield satisfactory long-term outcomes and a high union rate. Patients (aged ≥18 years) at a single institution with a symptomatic rib nonunion who underwent surgical rib stabilization of the nonunion coupled with bone autograft were evaluated (2010–2014). Pertinent clinical, operative, radiologic, and follow-up data were abstracted. Univariate analyses to assess the relationship of clinical outcomes were performed. Six patients underwent nonunion repair with autograft and plating. The mean time from injury to surgical repair of nonunion was 15 (66.1) months. A median of 3 [1–3] ribs were repaired with surgery. Postoperative radiographic union was demonstrated on cross-sectional imaging at three months in four patients (57%) and in all patients at five months postoperatively. No patients developed postoperative pulmonary hernia during follow-up. All patients had a significant reduction in median patient-reported pain at follow-up. Surgical rib fixation and bone autograft can provide acceptable outcomes for patients with rib fracture nonunion. This method provides pain relief and promotes healing of the nonunion gap without pulmonary hernia development. Operative fixation and bone autograft should be considered as a viable technical alternative to resection alone for rib nonunion.

Treatment of midshaft clavicular nonunion with plate fixation and autologous bone grafting

1995 ◽  
Vol 4 (5) ◽  
pp. 337-344 ◽  
Author(s):  
Bo Sanderhoff Olsen ◽  
Michael T. V˦sel ◽  
Jens O. Søjbjerg
Keyword(s):  
Bone Grafting ◽  
Plate Fixation ◽  
Autologous Bone Grafting ◽  
Autologous Bone

scholarly journals Sliding bone graft combined with double locking plate fixation for the treatment of femoral shaft nonunion

2019 ◽  
Vol 47 (5) ◽  
pp. 2034-2044 ◽  
Author(s):  
Wenzhao Xing ◽  
Zhenhua Pan ◽  
Lei Sun ◽  
Liang Sun ◽  
Chunpu Zhang ◽  
...  
Keyword(s):  
Bone Graft ◽  
Locking Plate ◽  
Plate Fixation ◽  
Femoral Shaft ◽  
Bony Union ◽  
Locking Plate Fixation ◽  
Duration Of Surgery ◽  
Novel Method ◽  
Mean Time

Objectives The aim of this study was to describe and evaluate a novel method of sliding bone graft combined with double locking plate fixation in treating femoral shaft nonunion. Methods Clinical data from patients with femoral shaft nonunion that was treated with sliding bone grafts combined with double locking plate fixation were retrospectively collected. Data included duration of surgery, blood loss, union rate, time to union and possible complications. Results Twenty-five patients included in the study were followed for a mean duration of 16.6 ± 2.6 months (range, 12–22 months). All of the fractures (100%) achieved bony union. Mean time to union was 6.0 ± 1.0 months (range, 4–8 months). No infections or medullary cavity occlusions were observed. Conclusions Sliding bone graft combined with double locking plate fixation was shown to be a safe, effective, and convenient surgical option for the treatment of nonunion, due to its high union rates with no complications. Further studies with larger sample sizes and longer-term follow-up are warranted.

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