fibular strut allograft
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2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Rita Moukarzel ◽  
Dany Aouad ◽  
Mohammad Daher ◽  
Wendy Ghanem ◽  
Hady Ezzeddine ◽  
...  

Supracondylar periprosthetic femoral fractures occurring above total knee replacements have been considered a rare entity. However, they continue to increase in frequency with the increasing number of arthroplasties and the improvement in morbidity and mortality in the concerned patient population. The management of periprosthetic distal femoral fractures is a challenging orthopedic problem. In this brief communication, a case of 49-year-old woman with rheumatoid arthritis who sustained a low distal comminuted periprosthetic femoral fracture is presented. Her fracture was eventually managed with an intramedullary fibular strut allograft and bilateral locking plate placement reaching satisfactory healing and restoration of alignment. The primary aim of this report is to provide insight into this novel technique as a successful alternative to other standard surgical options.


2020 ◽  
Vol 4 (4) ◽  
pp. 739-744
Author(s):  
Leslie A. Fink Barnes ◽  
Daniel F.H. Ruig ◽  
Christina E. Freibott ◽  
Rebecca Rajfer ◽  
Melvin P. Rosenwasser

2020 ◽  
Vol 24 (1) ◽  
pp. 7-12
Author(s):  
Joseph E. Manzi ◽  
Joseph J. Ruzbarsky ◽  
Ryan C. Rauck ◽  
Lawrence V. Gulotta ◽  
Joshua S. Dines ◽  
...  

2019 ◽  
Author(s):  
Xueliang Cui ◽  
Hui chen ◽  
Binbin Ma ◽  
Wenbin Fan ◽  
He Li

Abstract Abstract Background: Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs. Methods: A retrospective review was performed on 60 three- and four-part PHFs . The outcomes were assessed for 35 patients in the LCP group and 25 in the LCP with fibular allograft (FA) group, with a mean age of 72.75 years (60 to 88), at a mean follow-up of 31.95 months (24 to 40). Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). Loss of anatomic fixation was defined if the varus malalignment of the neck-shaft angle (NSA) was more than 5° or if the change in HHH was more than 3 mm. The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result: The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p<0.001] and NSA of 9.94° versus 3.12° [p﹤0.001 ]). The final average outcome scores were lower in the LCP group than in the FA group (CMS of 73.00 vs 78.96 [p=0.024] and ASES score of 72.80 vs 78.64 [p=0.022]). The FA group showed better forward elevation (p=0.010) and abduction (p=0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p<0.001). Conclusion: For comminuted PHFs in elderly patients, locking plate fixation with a fibular strut allograft showed satisfactory radiological and clinical outcomes. Trial registration: ZDYJLY(2018)New-9. Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University. URL of registry: http://www.njzdyy.com. Date of registration: 2018-05-17 Key words: proximal humeral fracture; fibular allograft; locking plate; elderly patients


2019 ◽  
Author(s):  
Xueliang Cui ◽  
Hui chen ◽  
Binbin Ma ◽  
Wenbin Fan ◽  
He Li

Abstract Abstract Background: Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs. Methods: A retrospective review was performed on 60 three- and four-part PHFs . The outcomes were assessed for 35 patients in the LCP group and 25 in the LCP with fibular allograft (FA) group, with a mean age of 72.75 years (60 to 88), at a mean follow-up of 31.95 months (24 to 40). Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). Loss of anatomic fixation was defined if the varus malalignment of the neck-shaft angle (NSA) was more than 5° or if the change in HHH was more than 3 mm. The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result: The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p<0.001] and NSA of 9.94° versus 3.12° [p﹤0.001 ]). The final average outcome scores were lower in the LCP group than in the FA group (CMS of 73.00 vs 78.96 [p=0.024] and ASES score of 72.80 vs 78.64 [p=0.022]). The FA group showed better forward elevation (p=0.010) and abduction (p=0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p<0.001). Conclusion: For comminuted PHFs in elderly patients, locking plate fixation with a fibular strut allograft showed satisfactory radiological and clinical outcomes. Trial registration: ZDYJLY(2018)New-9. Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University. URL of registry: http://www.njzdyy.com. Date of registration: 2018-05-17 Key words: proximal humeral fracture; fibular allograft; locking plate; elderly patients


2019 ◽  
Author(s):  
Xueliang Cui ◽  
Hui chen ◽  
Binbin Ma ◽  
Wenbin Fan ◽  
He Li

Abstract Purpose: The purpose of this study was to determine if fibular strut allograft influence reduction and clinical outcomes after locking plate fixation of comminuted proximal humeral fractures (PHFs). Methods: A retrospective review was performed on sixty 3- and 4-part PHFs treated with either locking plate only or locking plate with a fibular allograft. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). Loss of anatomic fixation was defined if the varus malalignment of neck-shaft angle (NSA) was more than 5°or if the change of humeral head height (HHH) was more than 3 mm. Clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score. Result: The average radiological changes were higher in the locking compression plate (LCP) group than in the locking plate with fibular allograft (FA) group ( HHH of 4.16mm versus 1.18mm [p﹤0.001] and NSA of 9.94° versus 3.12° [p﹤0.001 ]). Final average outcome scores were lower in LCP group than in FA group ( CMS of 73.00 versus 78.96 [p = 0.024] and ASES score of 72.80 versus 78.64 [p = 0.022]). FA group showed better forward elevation (P=0.010) and abduction (P=0.002), but no significant differences were observed for shoulder external rotation or internal rotation. Conclusion: For comminuted proximal humerus fractures in elderly patients with severe osteoporosis, locking plate fixation with a fibular strut allograft showed satisfactory radiological and clinical outcomes. Key words: proximal humeral fractures; locking compression plate; fibular allograft


2019 ◽  
Vol 101-B (3) ◽  
pp. 260-265 ◽  
Author(s):  
S. H. Lee ◽  
S. S. Han ◽  
B. M. Yoo ◽  
J. W. Kim

Aims The aim of this study was to evaluate the clinical and radiological outcomes of locking plate fixation, with and without an associated fibular strut allograft, for the treatment of displaced proximal humeral fractures in elderly osteoporotic patients. Patients and Methods We undertook a retrospective comparison of two methods of fixation, using a locking plate without an associated fibular strut allograft (LP group) and with a fibular allograft (FA group) for the treatment of these fractures. The outcome was assessed for 52 patients in the LP group and 45 in the FA group, with a mean age of 74.3 years (52 to 89), at a mean follow-up of 14.2 months (12 to 19). The clinical results were evaluated using a visual analogue scale (VAS) score for pain, the Constant score, the American Shoulder and Elbow Surgeons (ASES) score, and the range of movement. Radiological results were evaluated using the neck-shaft angle (NSA) and humeral head height (HHH). Results The mean forward elevation in the LP and FA groups was 125.3° (sd 21.4) and 148.9° (sd 19.8), respectively (p = 0.042), while other clinical factors showed no statistically significant differences between the groups. The changes in NSA and HHH immediately after the operation and at final follow-up were significantly better in the FA group than in the LP group (p = 0.015 and p = 0.021, respectively). Conclusion For comminuted proximal humeral fractures in osteoporotic patients, locking plate fixation with a fibular strut allograft shows satisfactory short-term results with respect to humeral head support and maintenance of reduction, and may reduce the incidence of complications associated with fixation using a locking plate alone. Cite this article: Bone Joint J 2019;101-B:260–265.


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