Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture. (10th April 2013)

• Record Type: Journal Article
• Authors: Divecha, Hiren M.; Marynissen, Hans A. J.
• Other Names: Erler K. Academic Editor.; Fisher D. A. Academic Editor.; Mayr J. Academic Editor.; Sakamoto A. Academic Editor.
• Is Part Of: Case reports in orthopedics. Volume 2013(2013)
• Publication Date: 2013-04-10
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedics; Periodicals; Electronic journals; Periodicals; 616.7
• DOI: 10.1155/2013/690906
• Languages: English
• ISSNs: 2090-6749

Abstract

Abstract : Distal humeral periprosthetic fractures below intramedullary nail devices are complex and challenging to treat, in particular due to the osteopenic/porotic nature of bone found in these patients. Fixation is often difficult to satisfactorily achieve around the intramedullary device, whilst minimising soft tissue disruption. Descriptions of such cases in the current literature are very rare. We present the case of a midshaft humeral fracture treated with a locking compression plate that developed a nonunion, in a 60-year old female. This went on to successful union after exchange for an intramedullary humeral nail. Unfortunately, the patient developed a distal 1/5th humeral periprosthetic fracture, which was then successfully addressed with a single-contoured, extra-articular, distal humeral locking compression plate (Synthes) with unicortical locking screws and cerclage cables proximally around the distal nail tip region. An excellent postoperative range of motion was achieved.