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AB0909 Septic pseudarthrosis of the humerus treatment using orthfix external fixation
  1. S Daas1,
  2. H Sahli2,
  3. MA Sbai1,
  4. M Souissi1,
  5. A Khorbi1
  1. 1Orthopedic Departement
  2. 2Rheumatology Departement, Mohamed Taher Maamouri University Hospital, nabeul, Tunisia

Abstract

Background The septic pseudarthrosis of the humerus is a very difficult process that poses a towfold challenge: the infection eradication while trying to get consolidation.

Objectives The aim of this study was to analyze the results of the treatment of septic pseudarthritis of the humerus with Orthofix monolateral axial external fixator.

Methods This is a retrospective study which included 17 medical records of patients treated for septic pseudarthritis of the humerus debridement and stabilization by Orthofix over a period of 7 years.

Results They were 13 women and 4 men with a mean age 44 years. The fracture site was most often at the distal half of the humerus. The initial treatment of the fracture was pinning or intramedullar nailing. Surgical management of pseudoarthrosis was performed 3.5 months after the first surgical procedure. All cases had a bone debridement and stabilization with a monoplane Orthofix axial external side. Fifteen cases had also a bone graft. The mean period of stabilization was 7months. Patients were evaluated clinically and radiologically each month. At the mean of three years of follow-up, we obtain osseous consolidation for all patients in the average of seven months. All patients underwent rehabilitation of the shoulder and elbow after treatment. The functional result were excellent results in 47% of cases, good results in 35,3% of cases and poor results in 17,7%. The Quick DASH score average was 28±5. The average of the elbow motion was 109 ° of flexion with an average of 30 °of deficit in extension. The useful range of motion of the elbow was preserved in 14 patients. There was a shaft angulation under 20 ° in 3 cases and over 20 ° in 3 other cases. We noted in four cases a bone shortening consolidations of 2 cm. We had a case of radial nerve neuraprexie which regressed spontaneously.

Conclusions Orthofix is the method of choice for the treatment of septic pseudarthritis of the humerus.

Associate eradication of the germ antibiotic and steroid intake spongy it allows the consolidation of the bone. Furthermore, the monolateral axial external fixator is tolerated well and allows movement of the shoulder and elbow throughout the period of treatment.

Disclosure of Interest None declared

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