Diaphyseal fracture-nonunion of forearm bone treated by compression plating aided with autologous bone grafting: A study outcome

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.

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

Case Reports in Medicine ◽

10.1155/2012/407349 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 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.

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Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02282-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Daniel Körner ◽

Christoph E. Gonser ◽

Stefan Döbele ◽

Christian Konrads ◽

Fabian Springer ◽

...

Keyword(s):

Surgical Treatment ◽

Bone Grafting ◽

Cartilage Damage ◽

Osteochondral Lesions ◽

Retrograde Drilling ◽

Autologous Bone Grafting ◽

Operation Rate ◽

Group A ◽

Autologous Bone ◽

Group B

Abstract Background The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. Methods Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. Results Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). Conclusions We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

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The Influence of an Occult Infection on the Outcome of Autologous Bone Grafting During Surgical Bone Reconstruction: A Large Single-Center Case-Control Study

Journal of Inflammation Research ◽

10.2147/jir.s297329 ◽

2021 ◽

Vol Volume 14 ◽

pp. 995-1005

Author(s):

Michael C Tanner ◽

Raban Arved Heller ◽

Andreas Grimm ◽

Stefan Zimmermann ◽

Maximilian Pilz ◽

...

Keyword(s):

Bone Grafting ◽

Case Control Study ◽

Case Control ◽

Bone Reconstruction ◽

Single Center ◽

Occult Infection ◽

Autologous Bone Grafting ◽

Autologous Bone ◽

Control Study

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Osteochondral defects of the talus treated with autologous bone grafting

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.86b4.14033 ◽

2004 ◽

Vol 86-B (4) ◽

pp. 521-526 ◽

Cited By ~ 54

Author(s):

D. Kolker ◽

M. Murray ◽

M. Wilson

Keyword(s):

Bone Grafting ◽

Osteochondral Defects ◽

Autologous Bone Grafting ◽

Autologous Bone

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Olecranon Apophyseal Nonunion in Adolescent Judo Players: A Report of Two Cases

Case Reports in Orthopedics ◽

10.1155/2018/8256074 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Kohei Yamaura ◽

Yutaka Mifune ◽

Atsuyuki Inui ◽

Hanako Nishimoto ◽

Yasuhiro Ueda ◽

...

Keyword(s):

Internal Fixation ◽

Bone Grafting ◽

Case Series ◽

Radiographic Evidence ◽

Level Of Evidence ◽

Old Patients ◽

Elbow Injury ◽

Autologous Bone Grafting ◽

Judo Athletes ◽

Autologous Bone

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.

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