ABSTRACT
Atypical fractures associated with prolonged bisphosphonate (BP) therapy rarely occur outside the femur, and the diagnostic criteria, appropriate treatment principles, and fixation methods for atypical ulnar fractures have not been established. The authors experienced the use of internal fixation with a metal plate and a new internal fixation method with an intramedullary nail in the treatment of an atypical ulnar fracture in a patient who had been on BP therapy for 10 to 20 years. This paper reports findings along with a review of the relevant literature.
Subject(s)
Humans , Femur , Fractures, Stress , Methods , Osteoporosis , UlnaABSTRACT
PURPOSE: To analyze the efficiency of simple step-cut translation osteotomy for cubitus varus and valgus deformity of the distal humerus, which was performed using a posterior approach and fixation of a Y-shaped metal plate. MATERIALS AND METHODS: In 20 cases that we were able to observe closely for more than 1year, we classified clinical and radio logical results according to the criteria of Oppenheim and Bellemore. RESULTS: Humerus-Elbow-Wrist angle had been corrected (from 16.6degrees to 7.6degrees in the cubitus varus and from 33.6degrees to 8.3degrees In the cubitus valgus). Change of the lateral and medial prominence index (average 8.38 from -15.74 to -7.36 in the cubitus varus and 7.25 from -17.68 to -10.43 in the cubitus valgus, respectively) provided satisfactory results with decreased protrusion on the medial and lateral condyles. In all cases except one, the range of motion was improved and results were good and excellent. CONCLUSION: Simple step-cut translation osteotomy for the distal humerus obtained very firm fixation with a wedge-shaped osteotomized surface and a Y-shaped metal plate, therefore, early movement was possible. Also because of the dfficiency of the translation osteotomy, we obtained cosmetically satisfactory resullts with a remarkable decreases in protrusion on the medial and lateral condyles.