Wenning KE, Schildhauer TA, Jones CB, Hoffmann MF. Derotational osteotomy and internal fixation of a 180° malrotated humerus: A case report. World J Orthop 2022; 13(10): 940-948 [PMID: 36312524 DOI: 10.5312/wjo.v13.i10.940]
Corresponding Author of This Article
Katharina Elisabeth Wenning, MD, Doctor, Surgeon, Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Buerkle de la Camp-Platz 1, Bochum 44789, Germany. katharina.wenning@bergmannsheil.de
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Oct 18, 2022; 13(10): 940-948 Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.940
Derotational osteotomy and internal fixation of a 180° malrotated humerus: A case report
Katharina Elisabeth Wenning, Thomas Armin Schildhauer, Clifford Barry Jones, Martin Franz Hoffmann
Katharina Elisabeth Wenning, Thomas Armin Schildhauer, Martin Franz Hoffmann, Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Bochum 44789, Germany
Clifford Barry Jones, Department of Orthopaedic Surgery, Creighton Medical School Phoenix, Phoenix, 85012, United States
Author contributions: Wenning KE helped with data collection, interpretation and writing the case report; Hoffmann MF contributed to study concept/design and data analysis; Jones CB, Schildhauer TA and Hoffmann MF helped with interpretation and contributed to the review of the final manuscript and final submission of the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Katharina Elisabeth Wenning, MD, Doctor, Surgeon, Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Buerkle de la Camp-Platz 1, Bochum 44789, Germany. katharina.wenning@bergmannsheil.de
Received: October 4, 2021 Peer-review started: October 4, 2021 First decision: January 11, 2022 Revised: March 28, 2022 Accepted: October 11, 2022 Article in press: October 11, 2022 Published online: October 18, 2022
Abstract
BACKGROUND
Humeral shaft fractures are relatively common in adults. Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare. To our knowledge, only three cases of symptomatic humeral malrotation have been reported. There are sparse literature reports of humeral reconstruction correction.
CASE SUMMARY
We present a case of extreme rotational deformity of the humerus (180°) after humeral shaft fracture. The patient complained of pain and difficulties with activities of daily living. In addition, she found the deformity cosmetically unacceptable. Therefore, she was searching for surgical correction. Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed. Postoperatively, the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up. The Disabilities of the Arm, Shoulder, and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.
CONCLUSION
Single-stage radial neurolysis, derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.
Core Tip: We present a case of extreme rotational deformity of the humerus (180°) after humeral shaft fracture. The patient complained about pain and difficulties with activities of daily living. A neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed. Postoperatively, the patient demonstrated transient iatrogenic radial nerve palsy which had complete recovery at 2 years postoperatively. The Disabilities of the Arm, Shoulder, and Hand score improved from a preoperative 55 to a final 16 at the final 2-year follow-up.
