THE USE OF A FIBULAR STRUT ALLOGRAFT WITH DBM, CANCELLOUS CHIPS AND BMP FOR A 10 CM HUMERAL SHAFT INFECTED NON-UNION: A CASE REPORT.

Pedro J Reyes Martínez, Pablo A Marrero Barrera
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Abstract

Humeral shaft non-unions occur in 2-10% of all fracture cases. Increased incidence of these non-unions can be associated with ORIF, comminution, high impact injuries, bone loss or fracture gaping. Treatment guidelines for fracture non-union state that fractures with gaps greater than 4 cm should be treated with vascularized fibular autografts or transportation with an external fixator. Unfortunately these modalities carry considerable donor site morbidity and patient will experience considerable discomfort, especially when dealing with an external fixator. This report demonstrates how the use of a nonvascularized fibular strut can be effectively utilized as an alternate treatment modality for large humeral shaft non-union gaps. Further studies should be conducted to support this method as a viable treatment option for non-union gaps greater than 4 cm.

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使用带dbm、松质芯片和BMP的腓骨支撑异体移植物治疗10厘米肱骨感染不愈合1例报告。
肱骨不连发生率为所有骨折病例的2-10%。这些骨不连发生率的增加可能与ORIF、粉碎、高冲击伤、骨丢失或骨折间隙有关。骨折不愈合的治疗指南认为,裂缝大于4cm的骨折应采用带血管的腓骨自体移植物或外固定架运输。不幸的是,这些方式携带相当大的供体部位发病率,患者将经历相当大的不适,特别是在处理外固定架时。本报告展示了非血管化腓骨支架如何有效地作为肱骨大骨不愈合间隙的替代治疗方式。进一步的研究应支持该方法作为大于4cm的骨不连间隙的可行治疗选择。
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