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Olecranon Nonunion after Operative Treatment of Fracture
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Ho Jung Kang, Ji Sup Kim, Myung Ho Shin, Il Hyun Koh, Yun Rak Choi
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J Korean Fract Soc 2015;28(1):30-37. Published online January 31, 2015
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DOI: https://doi.org/10.12671/jkfs.2015.28.1.30
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 Abstract
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- PURPOSE
Olecranon nonunion after surgical management is relatively rare, but it leads to limitation of motion of joint or instability. This retrospective study was conducted in order to analyze the cause and result of treatment.
MATERIALS AND METHODS
We analyzed 11 cases treated for nonunion of olecranon fractures. Nonunion was classified according to the spot of the lesion and the extent of articular surface damage. Evaluation was performed using Mayo elbow performance score (MEPS), Oxford elbow score (OES), Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the range of motion.
RESULTS
According to the spot of the lesion and the extent of articular surface damage, nonunion was categorized as IA (2 cases), IIA (5 cases), and IIIA (4 cases). One case of IA underwent nonunion fragment excision and the remaining cases were treated by bone grafting. A plate was used in seven cases and the other three cases had both plate and tension band wiring fixation. All nonunions finally became union. The 11 patients with one year follow-up had average MEPS of 87.7 points (range: 60-100 points), average OES of 43.2, and average DASH score of 18.8 points. Complications included limitation of motion (2 cases) and ulnar nerve symptoms (3 cases).
CONCLUSION
Bone grafting and fixation by plate may be beneficial. In addition, excision can be useful in type I.
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Treatment of Non-union Distal Humerus Fractures after Operation
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Hyung Sik Kim, Ki Joon Jang, Yun Rak Choi, Il Hyun Koh, Ho Jung Kang
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J Korean Fract Soc 2012;25(4):310-316. Published online October 31, 2012
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DOI: https://doi.org/10.12671/jkfs.2012.25.4.310
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Abstract
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- PURPOSE
This study is a retrospective analysis of patients who had undergone surgical treatment for non-union of distal humerus fracture. We evaluated them in terms of causes of injury, radiologic findings, and clinical outcomes such as prognosis.
MATERIALS AND METHODS
Seven consecutive radiologic patients who were confirmed to have nonunion of a distal humerus fracture underwent reoperations. These patients had already undergone operations for distal humerus fractures. This survey was held from 2005 to 2010. The average period up to diagnosis of non-union after the first operation was 7.4 months (4 to 16 months). The mean follow-up period was 24.6 months (12 to 65 months). Each patient was graded functionally according to the Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand Score.
RESULTS
Osteosynthesis was performed by internal fixation with plates and screws and then a bone graft for non-union of the distal humerus fracture. The average range of motion within the elbow joints was found to be a flexion contracture of 18.8 degrees (0~30 degrees) and further flexion of 120.2 degrees (102~140 degrees). Among postoperative complications, three cases of medium-degree stiffness, two cases of medial column nonunion, and one case of dissociation of the internal fixator were reported.
CONCLUSION
Stable internal fixation for maintenance reduction status is essential after accurate initial anatomical reduction. We concluded that nonunion could be prevented by additional surgical treatment such as autogenous bone graft, if it is necessary.
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Citations
Citations to this article as recorded by  - Autogenous Inlay Bone Graft for Distal Humerus Nonunion with Metaphyseal Bone Defect: A Technical Note
Yong-Suk Lee, Dongmin Kim, Min-Sung Kang, Jong-Hwa Park, Sang-Uk Lee
Archives of Hand and Microsurgery.2020; 25(1): 39. CrossRef
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