Prosthetic loosening and non-union

Case contributed by Dr Paul Simkin

Presentation

Routine follow up post-ORIF (open reduction and internal fixation).

Patient Data

Age: 65
Gender: Male
Modality: X-ray

Surgical plate and screws transfix a fracture of proximal shaft of the left ulna. This is unchanged in alignment since the previous study. Although there is bony callus formation around the fracture site, the fracture does not appear united and there are bony lucencies around the most proximal and most distal screws and more minor bony lucencies around some of the other screws. This suggests loosening of the prosthesis.

Modality: X-ray

Immediate post-operative fixation for comparison, 7 months prior to the current study.

Case Discussion

The findings in the case can be subtle, but comparison with the earlier images shows the increased lucency around the proximal and distal screws is a new finding. Coupled with the non-union of the fracture, this is consistent with prosthetic loosening and instability.

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Case Information

rID: 30477
Case created: 13th Aug 2014
Last edited: 17th Dec 2015
Inclusion in quiz mode: Included

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