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Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft

Objective: Open intra-articular fractures of the distal humerus can be associated with considerable bone loss and extensive soft tissue damage. The management of these injuries is quite challenging, and the restoration of elbow anatomy may require multiple bone and soft tissue surgical procedures. T...

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Autores principales: Kouvidis, George K, Chalidis, Byron E, Liddington, Mark I, Giannoudis, Peter V
Formato: Texto
Lenguaje:English
Publicado: Open Science Company, LLC 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374498/
https://www.ncbi.nlm.nih.gov/pubmed/18509480
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author Kouvidis, George K
Chalidis, Byron E
Liddington, Mark I
Giannoudis, Peter V
author_facet Kouvidis, George K
Chalidis, Byron E
Liddington, Mark I
Giannoudis, Peter V
author_sort Kouvidis, George K
collection PubMed
description Objective: Open intra-articular fractures of the distal humerus can be associated with considerable bone loss and extensive soft tissue damage. The management of these injuries is quite challenging, and the restoration of elbow anatomy may require multiple bone and soft tissue surgical procedures. The purpose of this case report is to present the option of addressing at the same time a complex skin, muscular, and bone distal humerus defect by using a composite vascularized graft. Methods: We present a case of a high-energy open fracture of the distal humerus in a polytrauma young patient. Apart from the significant damage of all skin layers and underlying muscle units at the posterolateral side of the elbow, the medial column of the distal humerus (6 cm in length) was completely absent. After patient resuscitation and wound debridement, a free vascularized osteocutaneous fibular graft was used for the reconstruction of the bone defect and the restoration of elbow anatomy. Results: No complications were encountered during the postoperative period, and both bone and soft tissues progressed to sound healing. At 26 months follow-up, the patient had a functional and stable elbow and the Mayo Elbow Performance Score was 85 points, which is equivalent to a good result. Conclusions: Vascularized osteocutaneous fibular graft could effectively address complex traumatic defects of the elbow joint and enhance the potential for bone healing and early functional recovery.
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spelling pubmed-23744982008-05-29 Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft Kouvidis, George K Chalidis, Byron E Liddington, Mark I Giannoudis, Peter V Eplasty Article Objective: Open intra-articular fractures of the distal humerus can be associated with considerable bone loss and extensive soft tissue damage. The management of these injuries is quite challenging, and the restoration of elbow anatomy may require multiple bone and soft tissue surgical procedures. The purpose of this case report is to present the option of addressing at the same time a complex skin, muscular, and bone distal humerus defect by using a composite vascularized graft. Methods: We present a case of a high-energy open fracture of the distal humerus in a polytrauma young patient. Apart from the significant damage of all skin layers and underlying muscle units at the posterolateral side of the elbow, the medial column of the distal humerus (6 cm in length) was completely absent. After patient resuscitation and wound debridement, a free vascularized osteocutaneous fibular graft was used for the reconstruction of the bone defect and the restoration of elbow anatomy. Results: No complications were encountered during the postoperative period, and both bone and soft tissues progressed to sound healing. At 26 months follow-up, the patient had a functional and stable elbow and the Mayo Elbow Performance Score was 85 points, which is equivalent to a good result. Conclusions: Vascularized osteocutaneous fibular graft could effectively address complex traumatic defects of the elbow joint and enhance the potential for bone healing and early functional recovery. Open Science Company, LLC 2008-04-29 /pmc/articles/PMC2374498/ /pubmed/18509480 Text en Copyright © 2008 The Author(s) http://creativecommons.org/licenses/by/2.0/ This is an open-access article whereby the authors retain copyright of the work. The article is distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Kouvidis, George K
Chalidis, Byron E
Liddington, Mark I
Giannoudis, Peter V
Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title_full Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title_fullStr Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title_full_unstemmed Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title_short Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft
title_sort reconstruction of a severe open distal humerus fracture with complete loss of medial column by using a free fibular osteocutaneous graft
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374498/
https://www.ncbi.nlm.nih.gov/pubmed/18509480
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