Nonunion of Humeral Intercondylar Comminuted Fracture Treated with Fibular Graft - A Case Report -

Abstract

Nonunion of comminuted distal humeral fracture is troublesome problem to orthopedic surgeon. We report a case of 59 years old woman, who suffered nonunion of comminuted distal humeral fracture previously treated by open reduction and internal fixation with plate and screws concomitantly autoiliac bone graft. We reconstructed humeral condyle with fibular inlay graft inside cortical shell of intercondylar bone fragment and obtained excellent result in radiological and functional outcome.Key Words: Humerus, Intercondylar fracture, Fibular graft, Non-union It has difficulty to treat distal humeral fracture in elderly over six decades because of extensive comminution and poor bone quality. Even though the bone defects due to severe comminution could be filled with iliac bone graft, the cancellous bone portion of iliac bone is easily resorbed. So, non-union was developed frequently in open reduction and internal fixation with iliac bone graft. In order to solve this problem, we could choose total elbow arthroplasty as alternative method for repairing non-union of distal humerus. But, complications of elbow arthroplasty itself are obstacle to choose this rising method. So, we reconstructed humeral condyle with fibular inlay graft making triangular structure inside cortical shell of intercondylar bone fragments. It obtained relatively good clinical result. So, we introduce this procedure for one of treatment option for repairing non-union of comminuted distal humeral fractures.