Yamazaki Takahiro, Matsuura Yusuke, Ohtori Seiji
Orthopaedic Surgery, Chiba University, Chiba, JPN.
Cureus. 2025 Apr 3;17(4):e81653. doi: 10.7759/cureus.81653. eCollection 2025 Apr.
Distal humeral fractures are relatively rare and are known to have a high nonunion rate compared to other humeral fracture sites. Treatment options for nonunion include open reduction and internal fixation (ORIF) and total elbow arthroplasty (TEA). While TEA has been increasingly reported as a treatment for distal humeral nonunion in recent years, it has limitations, including weight-bearing restrictions. This case report describes an 82-year-old female with a distal humeral nonunion that had been untreated for three years. Despite her advanced age and the prolonged time since injury, successful treatment was achieved with ORIF using dual plating technique and iliac bone grafting. Bone union was confirmed four months postoperatively, and the patient regained excellent elbow function with no pain or instability. This case suggests that ORIF can be a viable option even for elderly patients with long-standing distal humeral nonunion when appropriate surgical techniques are employed and articular surfaces are preserved.
肱骨远端骨折相对少见，与其他肱骨骨折部位相比，其骨不连发生率较高。骨不连的治疗选择包括切开复位内固定（ORIF）和全肘关节置换术（TEA）。虽然近年来越来越多报道将TEA用于治疗肱骨远端骨不连，但它存在局限性，包括负重限制。本病例报告描述了一名82岁女性，其肱骨远端骨不连已三年未治疗。尽管她年事已高且受伤后时间较长，但采用双钢板技术切开复位内固定及髂骨植骨仍成功实现了治疗。术后四个月确认骨愈合，患者恢复了良好的肘关节功能，无疼痛或不稳定。该病例表明，当采用适当的手术技术并保留关节面时，即使是患有长期肱骨远端骨不连的老年患者，切开复位内固定也可以是一种可行的选择。
