PDF(Pubmed)
Abstract：
Delayed fracture healing can have devastating functional consequences, including pseudoarthrosis. Many factors can contribute to delayed healing, including decreased vascularity, micro-motion at the fracture site, large fracture gaps, multiple traumas at the same site, compromised metabolic status, surgical complications, and other conditions. A 61-year-old female patient was referred to our hospital with left distal humeral pseudarthrosis, accompanied by chronic pain and disability. Two years prior, the patient suffered a traumatic incident. At another medical facility, the patient underwent open reduction and internal fixation surgery with simultaneous ulnar nerve transposition. She showed favorable postoperative recovery. Unfortunately, approximately one year later, the patient sustained a second trauma to the same arm. This led to peri-implant fracture and post-traumatic aseptic degradation of the osteosynthesis system which was subsequently removed. Twelve months after the last surgery, the patient was referred to our hospital and, after thorough consideration of the therapeutic options, we decided to perform left elbow arthroplasty with left distal humeral reconstruction by using Zimmer\'s Comprehensive Segmental Revision System. This approach is generally reserved for tumors, and only a handful of cases of megaprostheses for non-tumoral indications have been previously reported. The surgery and perioperative care of our patient were optimal, there were no complications, and the patient recovered arm functionality following rehabilitation.
摘要：
骨折延迟愈合会带来毁灭性的功能后果，包括假关节炎.许多因素会导致延迟愈合，包括血管减少，骨折部位的微动,大裂缝间隙，同一部位的多个创伤,受损的代谢状态，手术并发症,和其他条件。一名61岁的女性患者因左肱骨远端假关节被转诊到我们医院，伴有慢性疼痛和残疾。两年前,病人遭受了创伤。在另一个医疗机构，患者接受了切开复位内固定手术，同时进行尺神经转位。她的术后恢复良好。不幸的是,大约一年后,病人的同一只手臂遭受了第二次创伤。这导致植入物周围的骨折和创伤后的骨合成系统的无菌降解，随后将其移除。上次手术12个月后,病人被转诊到我们医院，在彻底考虑治疗选择后，我们决定使用Zimmer的综合节段修复系统进行左肘关节置换术和左肱骨远端重建。这种方法通常用于肿瘤，以前仅报道了少数用于非肿瘤适应症的大型假体病例。我们病人的手术和围手术期护理是最佳的，没有并发症,患者在康复后恢复了手臂功能。
