Cargando…

A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature

Interprosthetic humeral fractures (IHFs) are severe injury patterns associated with surgical issues and contradictory results. The knowledge and literature on this topic are still lacking. A 76 year-old woman was treated for a fracture occurred between the shoulder and elbow stemmed prosthesis. Seve...

Descripción completa

Detalles Bibliográficos
Autores principales: Marzano, Fabrizio, Pace, Valerio, Donantoni, Marco, Petruccelli, Rosario, Ceccarini, Paolo, Caraffa, Auro, Di Giacomo, Lorenzo Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680310/
https://www.ncbi.nlm.nih.gov/pubmed/36412756
http://dx.doi.org/10.3390/jfmk7040094
_version_ 1784834386563170304
author Marzano, Fabrizio
Pace, Valerio
Donantoni, Marco
Petruccelli, Rosario
Ceccarini, Paolo
Caraffa, Auro
Di Giacomo, Lorenzo Maria
author_facet Marzano, Fabrizio
Pace, Valerio
Donantoni, Marco
Petruccelli, Rosario
Ceccarini, Paolo
Caraffa, Auro
Di Giacomo, Lorenzo Maria
author_sort Marzano, Fabrizio
collection PubMed
description Interprosthetic humeral fractures (IHFs) are severe injury patterns associated with surgical issues and contradictory results. The knowledge and literature on this topic are still lacking. A 76 year-old woman was treated for a fracture occurred between the shoulder and elbow stemmed prosthesis. Severe bone loss was associated with the fracture. Treatment: Open reduction, plate fixation, and bone grafting were considered. A xenograft (used as a mechanical strut medially), a synthetic graft associated with bone growth factors, and scaffolds improved the bone healing process. Satisfactory clinical and radiological outcomes were obtained. A scoping review of the literature was also performed by the authors. Only eight papers reported IHFs with a low level of evidence. In total, eight patients were treated; one paper that reported on biomechanical aspects using finite element analysis is discussed. Conservative treatment leads to non-union, and the surgical approach is the gold standard. The osteosynthesis technique associated with bone grafting leads to the best outcomes. The use of a xenograft mechanical strut, associated with synthetic biological bone grafting, led to complete bone union at 9 months follow-up. Larger cohorts, more standardised results, and multicentric studies are mandatory in order to improve and establish a management and treatment algorithm.
format Online
Article
Text
id pubmed-9680310
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-96803102022-11-23 A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature Marzano, Fabrizio Pace, Valerio Donantoni, Marco Petruccelli, Rosario Ceccarini, Paolo Caraffa, Auro Di Giacomo, Lorenzo Maria J Funct Morphol Kinesiol Case Report Interprosthetic humeral fractures (IHFs) are severe injury patterns associated with surgical issues and contradictory results. The knowledge and literature on this topic are still lacking. A 76 year-old woman was treated for a fracture occurred between the shoulder and elbow stemmed prosthesis. Severe bone loss was associated with the fracture. Treatment: Open reduction, plate fixation, and bone grafting were considered. A xenograft (used as a mechanical strut medially), a synthetic graft associated with bone growth factors, and scaffolds improved the bone healing process. Satisfactory clinical and radiological outcomes were obtained. A scoping review of the literature was also performed by the authors. Only eight papers reported IHFs with a low level of evidence. In total, eight patients were treated; one paper that reported on biomechanical aspects using finite element analysis is discussed. Conservative treatment leads to non-union, and the surgical approach is the gold standard. The osteosynthesis technique associated with bone grafting leads to the best outcomes. The use of a xenograft mechanical strut, associated with synthetic biological bone grafting, led to complete bone union at 9 months follow-up. Larger cohorts, more standardised results, and multicentric studies are mandatory in order to improve and establish a management and treatment algorithm. MDPI 2022-10-26 /pmc/articles/PMC9680310/ /pubmed/36412756 http://dx.doi.org/10.3390/jfmk7040094 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Marzano, Fabrizio
Pace, Valerio
Donantoni, Marco
Petruccelli, Rosario
Ceccarini, Paolo
Caraffa, Auro
Di Giacomo, Lorenzo Maria
A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title_full A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title_fullStr A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title_full_unstemmed A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title_short A Novel Approach to Treat a Rare Case of Interprosthetic Humeral Fracture with Osteosynthesis and Combined Grafting: A Case Report and Review of the Literature
title_sort novel approach to treat a rare case of interprosthetic humeral fracture with osteosynthesis and combined grafting: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680310/
https://www.ncbi.nlm.nih.gov/pubmed/36412756
http://dx.doi.org/10.3390/jfmk7040094
work_keys_str_mv AT marzanofabrizio anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT pacevalerio anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT donantonimarco anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT petruccellirosario anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT ceccarinipaolo anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT caraffaauro anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT digiacomolorenzomaria anovelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT marzanofabrizio novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT pacevalerio novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT donantonimarco novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT petruccellirosario novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT ceccarinipaolo novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT caraffaauro novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature
AT digiacomolorenzomaria novelapproachtotreatararecaseofinterprosthetichumeralfracturewithosteosynthesisandcombinedgraftingacasereportandreviewoftheliterature