Fibular Strut Graft Along With Iliac Crest Graft As An Adjunct To Plating In Treatment Of Atrophic Non Union Fracture Shaft Of Humerus
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 11
Abstract
Study Design: Prospective study. Purpose: To evaluate functional and radiological outcome in patients with atrophic non union fracture shat of humerus. Methods: 7patients with atrophic non union involving shaft of humerus (proximal, middle and distal third) were included in the study, were managed by open reduction freshening of edges, intramedullary strut graft insertion followed by fixation with locking plates with iliac crest graft at the fracture site and were followed periodically between October 2016 to September 2018 .Clinical and radiological evaluations were performed regularly at 2 weeks, 1 month, 3 months, 6 months, 1 year, and then at 6-month intervalsStandard anteroposterior and lateral radiographs were obtained.DASH score was used to evaluate the functional results preoperatively and one year after the operation. Results: All the fractures united clinically and radiologically at a period between three months to six months. No patient developed any wound complication. Average shortening of the limbs was 23.28 mm. None of the patients had any neurovascular complication nor had any pain at the fracture sites. There was a significant improvement in the functionality of all the patient at the end of one year. Conclusions: Though there are several methods of fixation, management of atrophic non union of fracture shaft of humerus is technically demanding due to gross osteoporosis, reduced viability of bone ends and associated stiffness of proximal and distal joints. Addition of intramedullary fibular strut graft along with iliac crest cancellous graft adds to the stability of the fixation and its viability. Intramedullary presence of fibular strut graft increases the cortical hold by two folds and acts as an internal splint.
Authors and Affiliations
Dr Samratsmrutiranjan Sahoo, Dr Sujit Kumar Tripathy, Dr Vinay Prabhat, Dr Sandeep Velagada, Dr Doki Sunil Kumar, Dr Shakti Swaroop
Keywords
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- EP ID EP406783
- DOI 10.9790/0853-1711017175.
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