Orthopedic Department, Kasr EL Aini Hospital, Cairo University, Cairo, Egypt.
J Shoulder Elbow Surg. 2011 Sep;20(6):873-9. doi: 10.1016/j.jse.2011.04.021.
Nonunion of the supracondylar area of the humerus is a very difficult area to treat. The Ilizarov method has been shown to be effective in the treatment of nonunion of the humeral diaphysis. However, there is little in the literature regarding the treatment of nonunion of the supracondylar area especially in post-infection cases.
Eight patients with a mean age of 45.73 ± 11.42 years were treated for post-infection nonunion of the supracondylar area of the humerus with the Ilizarov method and followed up for 3 years. All had undergone at least 2 previous failed operations. The patients were evaluated radiologically and clinically with an outcome survey using the Disabilities of the Arm, Shoulder and Hand (DASH) score.
Solid union was achieved in all patients in a mean time of 6.87 ± 0.99 months. All patients had improvement in shoulder and elbow motion after treatment. The mean DASH score before surgery was 90.66 ± 5.66, whereas that after surgery was 24.62 ± 3.85. There was a significant improvement in the DASH score after surgery; the mean difference was 66.04 ± 1.81, with a t value of 35.88 (P < .001). All patients were satisfied with the treatment and returned to a more normal lifestyle with no pain, as well as complete soft-tissue recovery. None had recurrence of infection.
Ilizarov treatment for post-infection nonunion of the supracondylar humerus was shown to be effective, reliable, and tolerated by the patients.
肱骨髁上区域的不愈合是一个非常难以治疗的区域。伊利扎罗夫方法已被证明在治疗肱骨干的不愈合方面是有效的。然而，关于治疗肱骨髁上区域的不愈合，尤其是感染后病例的文献很少。
采用伊利扎罗夫方法治疗 8 例感染后肱骨髁上区域不愈合的患者，平均年龄为 45.73 ± 11.42 岁，随访 3 年。所有患者均至少接受过 2 次失败的手术。采用 Disabilities of the Arm, Shoulder and Hand（DASH）评分对患者进行影像学和临床评估。
所有患者在平均 6.87 ± 0.99 个月内均获得了骨性愈合。所有患者在治疗后肩部和肘部运动均有改善。手术前的 DASH 评分为 90.66 ± 5.66，而手术后为 24.62 ± 3.85。手术后 DASH 评分有显著改善，平均差异为 66.04 ± 1.81，t 值为 35.88（P <.001）。所有患者对治疗均满意，疼痛消失，生活方式更正常，软组织完全恢复，无感染复发。
伊利扎罗夫治疗感染后肱骨髁上不愈合是有效、可靠且可耐受的。
