Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique

Objectives: The objective of this study was to describe the surgical technique using an innovative nail-stem construct in treatment of periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty (TEA). Materials and Methods: Patients diagnosed with humeral recalcitrant...

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Main Authors: Yen-Sheng Chiang, Shih-Hao Chen, Keng-Chang Liu, Chang-Chen Yang, Jui-Teng Chien
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Tzu Chi Medical Journal
Subjects:
Online Access:http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=2;spage=171;epage=175;aulast=Chiang
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author Yen-Sheng Chiang
Shih-Hao Chen
Keng-Chang Liu
Chang-Chen Yang
Jui-Teng Chien
author_facet Yen-Sheng Chiang
Shih-Hao Chen
Keng-Chang Liu
Chang-Chen Yang
Jui-Teng Chien
author_sort Yen-Sheng Chiang
collection DOAJ
description Objectives: The objective of this study was to describe the surgical technique using an innovative nail-stem construct in treatment of periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty (TEA). Materials and Methods: Patients diagnosed with humeral recalcitrant nonunion in periprosthetic fractures and stem loosening after TEA were retrospectively recruited between 2018 and 2019. The demographic data and related clinical outcomes were recorded. We use a cutting length of the nail pushing into the humeral canal and then pull back distally to dock the tip of the humeral stem. The cement was packed into the humeral canal, and the periprosthetic bone defect was impacting with harvested allograft chip. Results: Patient age, gender, lesion site, number of previous surgeries, and the time period from the primary TEA to the nail-stem reconstruction were allocated. Moreover, the range of motion, degree of elbow stability, and level of pain were evaluated for each patient following this procedure. All the four patients achieved an optimal range of motion and secure stability with painless elbow at final follow-up. Conclusion: Our proposed nail-stem construct with double allogenous bone plate is a feasible alternative for revisional TEA in patients with implant loosening, periprosthetic humeral fractures, and recalcitrant nonunion.
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2223-8956
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publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-c6cf1dadeb42409b8a0ebc07fc1bdf2e2025-08-20T02:19:41ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562023-01-0135217117510.4103/tcmj.tcmj_193_22Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical techniqueYen-Sheng ChiangShih-Hao ChenKeng-Chang LiuChang-Chen YangJui-Teng ChienObjectives: The objective of this study was to describe the surgical technique using an innovative nail-stem construct in treatment of periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty (TEA). Materials and Methods: Patients diagnosed with humeral recalcitrant nonunion in periprosthetic fractures and stem loosening after TEA were retrospectively recruited between 2018 and 2019. The demographic data and related clinical outcomes were recorded. We use a cutting length of the nail pushing into the humeral canal and then pull back distally to dock the tip of the humeral stem. The cement was packed into the humeral canal, and the periprosthetic bone defect was impacting with harvested allograft chip. Results: Patient age, gender, lesion site, number of previous surgeries, and the time period from the primary TEA to the nail-stem reconstruction were allocated. Moreover, the range of motion, degree of elbow stability, and level of pain were evaluated for each patient following this procedure. All the four patients achieved an optimal range of motion and secure stability with painless elbow at final follow-up. Conclusion: Our proposed nail-stem construct with double allogenous bone plate is a feasible alternative for revisional TEA in patients with implant loosening, periprosthetic humeral fractures, and recalcitrant nonunion.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=2;spage=171;epage=175;aulast=Chiangimplant looseningnail-stem constructrecalcitrant nonunionrevision surgerytotal elbow arthroplasty
spellingShingle Yen-Sheng Chiang
Shih-Hao Chen
Keng-Chang Liu
Chang-Chen Yang
Jui-Teng Chien
Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
Tzu Chi Medical Journal
implant loosening
nail-stem construct
recalcitrant nonunion
revision surgery
total elbow arthroplasty
title Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
title_full Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
title_fullStr Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
title_full_unstemmed Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
title_short Nail-stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty: A surgical technique
title_sort nail stem construct method for periprosthetic humeral fractures with recalcitrant nonunion after total elbow arthroplasty a surgical technique
topic implant loosening
nail-stem construct
recalcitrant nonunion
revision surgery
total elbow arthroplasty
url http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=2;spage=171;epage=175;aulast=Chiang
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AT kengchangliu nailstemconstructmethodforperiprosthetichumeralfractureswithrecalcitrantnonunionaftertotalelbowarthroplastyasurgicaltechnique
AT changchenyang nailstemconstructmethodforperiprosthetichumeralfractureswithrecalcitrantnonunionaftertotalelbowarthroplastyasurgicaltechnique
AT juitengchien nailstemconstructmethodforperiprosthetichumeralfractureswithrecalcitrantnonunionaftertotalelbowarthroplastyasurgicaltechnique