title: Treatment of bone nonunion and bone defects associated with unsuccessful humeral condylar fracture repair with autogenous iliac bone reconstruction.
abstract: BACKGROUND
  Our preliminary study retrospectively assessed outcomes after the use of autogenous iliac bone grafts combined with internal fixation to repair refractory bone nonunions and bone defects associated with supracondylar or intracondylar humeral fractures, or both.
  
  
  METHODS
  We identified 22 patients (14 men and 8 women) with a mean age of 33.8 years (range, 17-60 years) with bone nonunion and severe bone defects associated with supracondylar or intercondylar humerus fractures, or both. The humeral condyle in each patient was anatomically reconstructed using autologous iliac bone grafts and internal fixation. Active functional exercise was initiated 3 to 4 weeks after surgery. The following variables were assessed: preoperative and postoperative elbow range of motion, Mayo Elbow Performance Score (MEPS), and postoperative complications.
  
  
  RESULTS
  Mean follow-up was 38.6 months. Mean duration until bone union was 5.6 months. Preoperatively, 16 patients had a fair or poor MEPS (<75). At final follow-up MEPS was excellent (>90) in 8, good (75-90) in 9, fair (60-74) in 4, and poor (<60) in 1 patient. Postoperative heterotopic ossification anterior to the elbow joint occurred in 2 patients.
  
  
  CONCLUSIONS
  Our preliminary results suggest that anatomic reconstruction of the humeral condyle using autogenous iliac bone grafting with internal fixation can improve elbow joint function in patients with bone nonunion and bone defects associated with supracondylar or intracondylar humeral fractures, or both. Larger scale studies are warranted to confirm our findings and compare the efficacy of this vs other surgical approaches.
authors: Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
authors: Yunfei
authors: Y
authors: Niu
authors: Yushu
authors: Y
authors: Bai
authors: Shuogui
authors: S
authors: Xu
authors: Dajiang
authors: D
authors: Wu
authors: Xinwei
authors: X
authors: Liu
authors: Panfeng
authors: P
authors: Wang
authors: Chuncai
authors: C
authors: Zhang
authors: Ming
authors: M
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D015331:Cohort Studies; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000534:rehabilitation; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D007085:Ilium / Q000637:transplantation*; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult