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2024, Number 2

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Ortho-tips 2024; 20 (2)

Refractory pseudoarthrosis of the humerus. From failure to resolution with blocked plate and autologous tricortical iliac crest graft. Application of the diamond concept

Reyes PA, Sánchez AR, Gutiérrez-Mendoza I, López AL, Reyes PR, Barriga MMA, Silva MJA, Izquierdo MJF, Téllez AIR

Language: Spanish
References: 25
Page: 110-118
PDF size: 433.83 Kb.


ABSTRACT

Introduction: different techniques have been described for the treatment of nonunion. However, there are very few reports on the use of autologous tricortical iliac crest graft. The objective of reporting this case is to emphasize the importance of using the autologous tricortical iliac crest graft, in the context of the "diamond concept", after 3 failed surgeries for humerus nonunion. Case report: female, 69 years old, type 2 diabetes mellitus, grade III obesity, diagnosis of aseptic oligotrophic nonunion of the right humerus plus radial nerve injury, underwent 3 previous surgeries without success in resolution. The treatment consisted of performing osteosynthesis with an locking compression plate (LCP) for the proximal humerus and application of the "diamond concept" through the use of autologous tricortical iliac crest graft, bone marrow aspirate, platelet-rich plasma and demineralized bone matrix, as well as exploration and decompression of the radial nerve, achieving complete consolidation and functional recovery. Conclusion: after 3 failed surgeries, and after a bone loss of 7 cm, complete bone consolidation and full functional recovery are achieved through the application of the "diamond concept" with the complement of the use of autologous tricortical iliac crest graft.


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