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Traumatic Humeral Diaphysis Extrusion and Replantation With Periosteal Involvement.
Wyatt McGilvery1,2, Christian Hasson1, Montri Daniel Wongworawat3
1A.T. Still University College of Osteopathic Medicine, Mesa, AZ, USA.
Journal of Medical Cases
|September 21, 2022
Summary
This case study details the successful replantation of an extruded humeral diaphysis fragment, a rare orthopedic injury. Proper bone fragment preservation and sterilization techniques are crucial for optimizing outcomes in severe open fractures.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- Bone Reconstruction
Background:
- Open fractures with extruded long bone diaphysis are rare and present complex management challenges.
- Surgical options include fragment replantation, bone transport, vascularized fibular graft, or allograft reconstruction, each with significant risks.
Observation:
- A 35-year-old female sustained a humeral diaphysis fracture and expulsion after a high-speed motor vehicle collision.
- The extruded 6-inch humeral fragment was recovered from the patient's vehicle and preserved for 2 days at -20 °C.
Findings:
- The recovered humeral fragment was successfully utilized as an autograft for open reduction internal fixation.
- This case highlights techniques for bone fragment storage, sterilization, and replantation in trauma patients.
Implications:
- Proper management of extruded bone fragments can optimize replantation success and union rates.
- This approach offers a viable alternative to allograft reconstruction in select cases of severe open fractures.
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