Surgical treatment of proximal ulna nonunion.

Roberto Rotini, Diego Antonioli, Alessandro Marinelli, Dragana Katusić

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We reviewed our experience in the surgical treatment of 12 cases of proximal ulna nonunion. The primary injuries were 2 fracture-dislocations of the olecranon, 6 Monteggia lesions and 3 isolated fractures of the proximal ulna. According to the type of primary injury and its anatomical site, the nonunions were classified into 2 groups, considering that the nonunions nearest to the humerus-ulna joint present a more disabling clinical profile and are more difficult to treat: group A (6 patients - nonunion within 5 cm from the olecranon tip of the olecranon) and group B (6 patients - nonunion between 5 and 10 cm from the olecranon tip of the olecranon). In all cases, after fibrous callus debridement and bone surface remodelling, fixation was performed with plate and screws and homoplastic cortical bone graft (orthogonal or parallel to the plate) and an intercalary bone cylinder when the bone defect was severe. In 3 patients (group A), where the defect was smaller than 1 cm, fixation of the ulna was combined with a resection of the radial neck. Clinical-radiographic healing was achieved in all patients followed for a mean of 27 months. Complications included a case of nonunion due to failure of the intercalary graft with plate breakage. The patient healed after a new surgery performed with same technique. The score, according to the Broberg-Morrey scoring system, was 78 in group A patients and 93 in group B patients. The use of homoplastic cortical bone graft represents an effective technique to improve the mechanical properties of the fixation and supports biological union, even when the bone defect is severe.

Original languageEnglish
Pages (from-to)65-70
Number of pages6
JournalLa Chirurgia degli organi di movimento
Volume91
Issue number2
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Ulna
Olecranon Process
Transplants
Therapeutics
Ulna Fractures
Bone Plates
Bone and Bones
Bone Remodeling
Humerus
Wounds and Injuries
Bony Callus
Debridement
Neck
Joints

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Surgical treatment of proximal ulna nonunion. / Rotini, Roberto; Antonioli, Diego; Marinelli, Alessandro; Katusić, Dragana.

In: La Chirurgia degli organi di movimento, Vol. 91, No. 2, 02.2008, p. 65-70.

Research output: Contribution to journalArticle

Rotini, Roberto ; Antonioli, Diego ; Marinelli, Alessandro ; Katusić, Dragana. / Surgical treatment of proximal ulna nonunion. In: La Chirurgia degli organi di movimento. 2008 ; Vol. 91, No. 2. pp. 65-70.
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