Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

Abstract

Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

A Case of Nonunion with Ballooning Deformity after Periprosthetic Humeral Fracture

“…If there is looseness, revision with a longer stem by using a plate and/or bone graft is recommended [ 3 ]. There are some reports recommending revision using strut bone allograft and internal fixation using a plate or cable system when the bone is fragile due to loosening [ 4 , 5 , 6 ]. In this case, as well, we examined options including osteosynthesis using bone grafts such as autograft and allograft.…”

Hybrid Fixation of Failed Internally Fixed Distal Femoral Fracture with an Extramedullary Locking Plate and an Intramedullary Cortical Strut Allograft Construct- A Case Report

“…Left lateral table supports were applied to the radiolucent operating table to enable the tilting of the table. and knee revision arthroplasty procedures, peri-prosthetic fractures, avascular necrosis, tumour surgery, non-union of fractures and in spine surgery [6][7][8][9][10][11][12]. However, the use of strut grafts for a hybrid plate/structural allograft construct (PAC) for primary or failed internal fixation of long bone fractures in elderly patients with osteoporosis hasn't really been explored.…”