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Outcomes of Humerus Nonunion Surgery in Patients With Initial Operative Fracture Fixation.
Harrison, Noah; Hysong, Alexander; Posey, Samuel; Yu, Ziqing; Chen, Andrew T; Pallitto, Patrick; Gardner, Michael J; Dumpe, Jarrod; Mir, Hassan; Babcock, Sharon; Natoli, Roman M; Adams, John D; Zura, Robert D; Miller, Anna N; Seymour, Rachel B; Hsu, Joseph R; Obremskey, William.
Afiliación
  • Harrison N; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
  • Hysong A; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  • Posey S; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  • Yu Z; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  • Chen AT; Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Pallitto P; Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Gardner MJ; Department of Orthopaedic Surgery, Stanford University, Stanford, CA.
  • Dumpe J; Department of Orthopaedic Surgery, Atrium Health Navicent Medical Center, Macon, GA.
  • Mir H; Department of Orthopaedic Surgery, Florida Orthopedic Institute, Tampa, FL.
  • Babcock S; Department of Orthopaedic Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, NC.
  • Natoli RM; Department of Orthopaedic Surgery, Indiana University School of Medicine, IU Health Methodist Hospital, Indianapolis, IN.
  • Adams JD; Department of Orthopaedic Surgery, Prisma Health, Greenville, SC.
  • Zura RD; Department of Orthopaedics, Louisiana State University, New Orleans, LA; and.
  • Miller AN; Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
  • Seymour RB; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  • Hsu JR; Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  • Obremskey W; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
J Orthop Trauma ; 38(3): 168-175, 2024 Mar 01.
Article en En | MEDLINE | ID: mdl-38158607
ABSTRACT

OBJECTIVES:

To describe outcomes following humerus aseptic nonunion surgery in patients whose initial fracture was treated operatively and to identify risk factors for nonunion surgery failure in the same population.

DESIGN:

Retrospective case series.

SETTING:

Eight, academic, level 1 trauma centers. PATIENTS SELECTION CRITERIA Patients with aseptic humerus nonunion (OTA/AO 11 and 12) after the initial operative management between 1998 and 2019. OUTCOME MEASURES AND COMPARISONS Success rate of nonunion surgery.

RESULTS:

Ninety patients were included (56% female; median age 50 years; mean follow-up 21.2 months). Of 90 aseptic humerus nonunions, 71 (78.9%) united following nonunion surgery. Thirty patients (33.3%) experienced 1 or more postoperative complications, including infection, failure of fixation, and readmission. Multivariate analysis found that not performing revision internal fixation during nonunion surgery (n = 8; P = 0.002) and postoperative de novo infection (n = 9; P = 0.005) were associated with an increased risk of recalcitrant nonunion. Patient smoking status and the use of bone graft were not associated with differences in the nonunion repair success rate.

CONCLUSIONS:

This series of previously operated aseptic humerus nonunions found that more than 1 in 5 patients failed nonunion repair. De novo postoperative infection and failure to perform revision internal fixation during nonunion surgery were associated with recalcitrant nonunion. Smoking and use of bone graft did not influence the success rate of nonunion surgery. These findings can be used to give patients a realistic expectation of results and complications following humerus nonunion surgery. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas Óseas / Fracturas no Consolidadas / Fracturas del Húmero Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas Óseas / Fracturas no Consolidadas / Fracturas del Húmero Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos