title: Definitive treatment in a spiral-fracture of the distal humerus shaft with severe osteoporosis after two failed osteosynthesis: problem and solution. A case report and literature review.
abstract: BACKGROUND
  Osteoporotic fractures in the elderly are often complicated by delayed union, pseudarthrosis or implant failure and are associated with considerable morbidity and prolonged reconvalescence. At present there is cumulating recommendation to treat this kind of fractures with angular stable implants.
  
  
  METHODS
  Herein, we report on the successful definitive treatment of a displaced comminuted spiral-fracture of the distal humerus shaft in an 89-year-old woman after two attempts of internal fixation with angular stable implants had failed in severely osteoporotic bone.
  
  
  CONCLUSIONS
  The present case illustrates the problems we have faced with after a single locking plate fixation, especially in poor bone, and shows a possible solution by performing a double(-locking)-plate fixation.
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany. frank.martetschlaeger@gmx.de.
authors.forename: F
authors.initials: F
authors.lastname: Martetschlaeger
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Siebenlist
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Sandmann
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kraus
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Stoeckle
authors.affiliation: Department of Traumatology, Klinikum Rechts der Isar, TU München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lucke
keywords: Fractures; Implants for osteosynthesis; Orthopedic trauma; Osteoporosis; Revision surgery; Upper extremity
references.citation: Acta Chir Orthop Traumatol Cech. 2005;72(2):89-97
references.pmid: 15890140
references.citation: Injury. 2003 Nov;34 Suppl 2:B1-3
references.pmid: 14580979
references.citation: Acta Orthop Scand. 1999 Jun;70(3):283-5
references.pmid: 10429606
references.citation: J Trauma. 2009 Mar;66(3):795-9
references.pmid: 19276755
references.citation: J Trauma. 2006 Apr;60(4):830-5
references.pmid: 16612304
references.citation: J Bone Joint Surg Br. 2002 Nov;84(8):1093-110
references.pmid: 12463652
references.citation: J Orthop Trauma. 2004 May-Jun;18(5):286-93
references.pmid: 15105750
references.citation: J Orthop Traumatol. 2008 Sep;9(3):149-53
references.pmid: 19384611
references.citation: Injury. 2005 Jan;36(1):110-22
references.pmid: 15589929
references.citation: J Orthop Trauma. 2004 Sep;18(8):483-7
references.pmid: 15475842
references.citation: J Orthop Trauma. 2004 Sep;18(8):481-2
references.pmid: 15475841
references.citation: Injury. 2007 Sep;38 Suppl 3:S35-9
references.pmid: 17723790
references.citation: J Orthop Trauma. 2004 Sep;18(8):571-7
references.pmid: 15475856
references.citation: Injury. 2003 Nov;34 Suppl 2:B31-42
references.pmid: 14580984
references.citation: J Bone Joint Surg Br. 2006 Oct;88(10):1272-8
references.pmid: 17012413
references.citation: Clin Orthop Relat Res. 2005 May;(434):222-30
references.pmid: 15864057
references.citation: Clin Orthop Relat Res. 2004 Aug;(425):50-4
references.pmid: 15292787
references.citation: J Orthop Trauma. 1993;7(5):438-42
references.pmid: 8229380
references.citation: Orthopedics. 2001 Mar;24(3):249-52
references.pmid: 11300289
references.citation: J Orthop Trauma. 1990;4(3):260-4
references.pmid: 2231122
references.citation: J Biomech Eng. 1996 Aug;118(3):391-8
references.pmid: 8872262