Leiblein Maximilian, Verboket Rene, Marzi Ingo, Wagner Nils, Nau Christoph
Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University, Frankfurt, D-60590, Frankfurt am Main, Germany.
Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University, Frankfurt, D-60590, Frankfurt am Main, Germany.
Chin J Traumatol. 2019 Aug;22(4):187-195. doi: 10.1016/j.cjtee.2019.04.002. Epub 2019 May 4.
Fractures of the humerus account for 5%-8% of all fractures. Nonunion is found with an incidence of up to 15%, depending on the location of the fracture. In case of a manifest nonunion the surgeon faces a challenging problem and has to conceive a therapy based on the underlying pathology. The aim of this study was to describe our treatment concepts for this entity and present our results of the last five years.
Twenty-six patients were treated for nonunion of the humerus between January 2013 and December 2017. Their charts were reviewed retrospectively and demographic data, pathology, surgical treatment and outcome were assessed.
The most frequent location for a nonunion was the humeral shaft, with the most common trauma mechanism being multiple falls. Most often atrophic nonunion (n = 14), followed by hypertrophic and infection-caused nonunion (each n = 4), were found. Our treatment concept could be applied in 19 patients, of which in 90% of those who were available for follow-up consolidation could be achieved.
Humeral nonunion is a heterogeneous entity that has to be analyzed precisely and be treated correspondingly. We therefore present a treatment concept based on the underlying pathology.
肱骨骨折占所有骨折的5%-8%。根据骨折部位不同，骨不连的发生率高达15%。对于明显的骨不连，外科医生面临着一个具有挑战性的问题，必须根据潜在的病理情况构思治疗方案。本研究的目的是描述我们针对该病症的治疗理念，并展示我们过去五年的治疗结果。
2013年1月至2017年12月期间，对26例肱骨骨不连患者进行了治疗。回顾性查阅他们的病历，评估人口统计学数据、病理情况、手术治疗及结果。
骨不连最常见的部位是肱骨干，最常见的创伤机制是多次跌倒受伤。最常出现萎缩性骨不连（n = 14），其次是肥大性骨不连和感染性骨不连（各n = 4）。我们的治疗理念适用于19例患者，其中90%可进行随访的患者实现了骨愈合。
肱骨骨不连是一种异质性病症，必须进行精确分析并相应地进行治疗。因此，我们提出一种基于潜在病理情况的治疗理念。
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