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Contoured plating for proximal ulna nonunion: an improved technique.
Ayman Khalil1, Mohamed Elsayed, Osama Seleem
1Faculty of Medicine, Department of Orthopedics, Tanta University, Tanta, Egypt. aymkhalil41@hotmail.com
International Orthopaedics
|May 28, 2009
Summary
This study shows that using contoured plating augmented with an intramedullary lag screw effectively treats proximal ulna nonunion, promoting early patient mobilization and high union rates.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
Background:
- Proximal ulna nonunion presents a significant challenge in orthopedic surgery.
- Effective fixation strategies are crucial for restoring function and preventing complications.
Purpose of the Study:
- To evaluate the efficacy of contoured plating augmented with an intramedullary lag screw for treating proximal ulna nonunion.
- To assess union rates, complication profiles, and functional outcomes.
Main Methods:
- Twenty-one patients with proximal ulna nonunion underwent surgical treatment.
- A contoured plate was applied, augmented with a 6.5-mm intramedullary cancellous lag screw in the proximal hole.
- Patients were followed for an average of 22 months.
Main Results:
- Successful union was achieved in 19 out of 21 cases (90.5%) within a mean of 9.6 weeks.
- Complications included persistent nonunion (2 cases), elbow stiffness (1 case), hardware prominence (2 cases), and superficial ulceration (1 case).
- Two cases with unsatisfactory outcomes were attributed to ulnohumeral arthritis.
Conclusions:
- Augmenting contoured plating with a 6.5-mm intramedullary cancellous lag screw provides a stable construct for proximal ulna nonunion.
- This technique allows for axial compression, resists bending forces, and facilitates early postoperative mobilization.
