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Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures.

Publication ,  Journal Article
Christiano, AV; Pean, CA; Leucht, P; Konda, SR; Egol, KA
Published in: Eur J Orthop Surg Traumatol
July 2020

PURPOSE: The purpose of this study is to determine if the radiographic humerus union measurement (RHUM) is predictive of union in humeral shaft fractures treated nonoperatively. METHODS: All patients with long bone fracture nonunion presenting to a single surgeon were enrolled in a prospective registry. This registry was queried to identify patients with humeral shaft fractures treated nonoperatively and developed nonunion. The nonunion cohort was matched to a three to one gender- and age-matched control group that were treated nonoperatively for a humeral shaft fracture and achieved union. Two fellowship-trained orthopedic traumatologists blinded to eventual union scored radiographs obtained 12 weeks after injury using the RHUM. A binomial logistic regression determined the effect of the RHUM on the likelihood of developing union. RESULTS: Nine patients with humeral shaft fractures treated nonoperatively with radiographs 12 weeks after injury that developed nonunion were identified. These patients were matched to 27 controls. Logistic regression demonstrated the RHUM was a significant predictor of healing 12 weeks after humeral shaft fracture treated nonoperatively (p = 0.014, odds ratio 9.434, 95% CI for OR 1.586-56.098). All patients with RHUM below 7 went on to nonunion. All patients with RHUM above 8 healed. Three of seven patients (43%) with RHUM of 7 or 8 healed. CONCLUSION: The RHUM demonstrated an increased likelihood of achieving union 12 weeks after injury. Orthopedic surgeons can counsel patients that fractures with RHUM scores of 6 or below are in danger of developing nonunion and can target interventions appropriately.

Duke Scholars

Published In

Eur J Orthop Surg Traumatol

DOI

EISSN

1432-1068

Publication Date

July 2020

Volume

30

Issue

5

Start / End Page

835 / 838

Location

France

Related Subject Headings

  • Radiography
  • Predictive Value of Tests
  • Orthopedics
  • Middle Aged
  • Male
  • Humeral Fractures
  • Humans
  • Fractures, Ununited
  • Fracture Healing
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Christiano, A. V., Pean, C. A., Leucht, P., Konda, S. R., & Egol, K. A. (2020). Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures. Eur J Orthop Surg Traumatol, 30(5), 835–838. https://doi.org/10.1007/s00590-020-02635-0
Christiano, Anthony V., Christian A. Pean, Philipp Leucht, Sanjit R. Konda, and Kenneth A. Egol. “Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures.Eur J Orthop Surg Traumatol 30, no. 5 (July 2020): 835–38. https://doi.org/10.1007/s00590-020-02635-0.
Christiano AV, Pean CA, Leucht P, Konda SR, Egol KA. Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures. Eur J Orthop Surg Traumatol. 2020 Jul;30(5):835–8.
Christiano, Anthony V., et al. “Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures.Eur J Orthop Surg Traumatol, vol. 30, no. 5, July 2020, pp. 835–38. Pubmed, doi:10.1007/s00590-020-02635-0.
Christiano AV, Pean CA, Leucht P, Konda SR, Egol KA. Scoring of radiographic cortical healing with the radiographic humerus union measurement predicts union in humeral shaft fractures. Eur J Orthop Surg Traumatol. 2020 Jul;30(5):835–838.
Journal cover image

Published In

Eur J Orthop Surg Traumatol

DOI

EISSN

1432-1068

Publication Date

July 2020

Volume

30

Issue

5

Start / End Page

835 / 838

Location

France

Related Subject Headings

  • Radiography
  • Predictive Value of Tests
  • Orthopedics
  • Middle Aged
  • Male
  • Humeral Fractures
  • Humans
  • Fractures, Ununited
  • Fracture Healing
  • Female