Neglected Infection of Supracondylar Humerus with Non-Prosthetic Peri-Implant Fractures (NPPIF): Case Report
DOI:
https://doi.org/10.31282/joti.v7n1.125Keywords:
Non peri-implant fracture, Fracture-related infection, Proximal humerus fracture, Hinged bar external fixationAbstract
Introduction: Proximal humerus fractures in adults are one of the most common fractures with an incidence of approximately 6%. However, a non-prosthetic peri-implant fracture combined with neglected infection is still underreported. So far, no journal has been concerned about this topic, and we want to discuss our comprehensive management in this case.
Case Presentation: A 70-year-old female complained of pain in her right elbow after falling on her house. Fractures got infected after a week of being neglected by the patient. She had a history of open reduction and internal fixation with plate and screws seventeen years ago. She was diagnosed with neglected infection peri-implant fracture right supracondylar humerus Non-prosthetic Peri-Implant Fractures (NPPIF) Classification P1B and scheduled for debridement, removal implant, external fixation with hinged bar. Infection was treated according to the wound culture result.
Conclusion: Comprehensive management is needed in this kind of case. Our goal in this case is to stabilize the fracture and heal the infection. This patient has a good prognosis and make a functional return.
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References
DeGenova, D. T., Glazier, M. T., Schrock, J. B., Skura, B. W., Hockman, T. N., & Taylor, B. C. Peri-implant Proximal Humerus Fracture Stabilized with Stacked Plating: A Case Report. Journal of orthopaedic case reports. 2023;13(3), 8–12. https://doi.org/10.13107/jocr.2023.v13.i03.3564
Pencle FJ, Varacallo M. Proximal Humerus Fracture. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470346/
Chan, L. W. M., Gardner, A. W., Wong, M. K., Chua, K., Kwek, E. B. K., & Singapore Orthopaedic Research CollaborativE (SORCE). Non-prosthetic peri-implant fractures: classification, management and outcomes. Archives of orthopaedic and trauma surgery. 2018;138(6), 791–802. https://doi.org/10.1007/s00402-018-2905-1
McNally, M., Govaert, G., Dudareva, M., Morgenstern, M., & Metsemakers, W. J. Definition and diagnosis of fracture-related infection. EFORT open reviews. 2020;5(10), 614–619. https://doi.org/10.1302/2058-5241.5.190072
Lu, V., Zhang, J., Patel, R., Zhou, A. K., Thahir, A., & Krkovic, M. Fracture Related Infections and Their Risk Factors for Treatment Failure-A Major Trauma Centre Perspective. Diagnostics (Basel, Switzerland). 2022;12(5), 1289. https://doi.org/10.3390/diagnostics12051289
Metsemakers, W. J., Morgenstern, M., Senneville, E., Borens, O., Govaert, G. A. M., Onsea, J., Depypere, M., Richards, R. G., Trampuz, A., Verhofstad, M. H. J., Kates, S. L., Raschke, M., McNally, M. A., Obremskey, W. T., & Fracture-Related Infection (FRI) group. General treatment principles for fracture-related infection: recommendations from an international expert group. Archives of orthopaedic and trauma surgery. 2020;140(8), 1013–1027. https://doi.org/10.1007/s00402-019-03287-4
Sen, D. Principles and Overview of External Fixators. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. 2022. https://doi.org/10.1007/978-981-15-6278-5_16-1
Iordens GIT, Den Hartog D, Van Lieshout EMM, Tuinebreijer WE, De Haan J, Patka P, et al. Good functional recovery of complex elbow dislocations treated with hinged external fixation: a multicenter prospective study. Clin Orthop Relat Res. 2014;473(4):1451–1461. doi: 10.1007/s11999-014-3959-1.
Van Tunen, B., Van Lieshout, E. M. M., Mader, K., & Den Hartog, D. Complications and range of motion of patients with an elbow dislocation treated with a hinged external fixator: a retrospective cohort study. European journal of trauma and emergency surgery : official publication of the European Trauma Society. 2022;48(6), 4889–4896. https://doi.org/10.1007/s00068-022-02013-x
