Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2021

01-12-2021 | Research article

Do the successful revision surgery for humeral nonunion solve all the effects on health‐related quality of life? A retrospective cohort study

Authors: Zhimeng Wang, Yao Lu, Liang Sun, Leilei Song, Teng Ma, Qiang Wang, Kun Zhang, Zhong Li

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Login to get access

Abstract

Background

The aim of this study is to evaluate the effects of successful revision operation on health quality of life(QoL) and functional outcome in humeral nonunion patients.

Methods

This retrospective study included 62 patients with humeral nonunion from Northwest China, who were admitted to the Department of Trauma Surgery, Honghui Hospital between March 2013 and September 2019. The following data were retrospectively evaluated: demographic data, clinical data, imaging findings, and treatment methods. The QoL assessment indicators for humeral nonunion patients included the SF-12 mental component summary (MCS) and physical component summary (PCS),brief pain inventory-severity(BPI-S) and brief pain inventory-interference (BPI-I). The mayo elbow performance score (MEPS) was used to assess the elbow function of the patients.

Results

Successful revision surgery significantly improved the patient's PCS, MCS, BPI-S and BPI-I scores (p<0.001). According to the MEPS criteria, the excellent and good rates were 95.16% in this study. The impact of humeral nonunion on mental health was comparable with the reported impact of stroke and type II diabetes (p>0.05).The impact of post-op on physical health was comparable with the reported impact of COPD, silicosis, hypertension, barrentt’s esophagus and lower urinary tract symptoms(p>0.05).

Conclusion

Humeral nonunion is a devastating chronic medical condition that negatively affects both physical and mental health as well as quality of life. Although the effects of pain in the body can be completely relieved by treatment, the entire medical process may cause everlasting psychological trauma to the patient.
Literature
1.
go back to reference Ekholm R, Tidermark J, Tornkvist H, Adami J, Ponzer S. Outcome after closed functional treatment of humeral shaft fractures. J Orthop Trauma. 2006;20(9):591–6.PubMedCrossRef Ekholm R, Tidermark J, Tornkvist H, Adami J, Ponzer S. Outcome after closed functional treatment of humeral shaft fractures. J Orthop Trauma. 2006;20(9):591–6.PubMedCrossRef
2.
go back to reference Peters RM, Claessen FM, Doornberg JN, Kolovich GP, Diercks RL, van den Bekerom MP. Union rate after operative treatment of humeral shaft nonunion–A systematic review. Injury. 2015;46(12):2314–24.PubMedCrossRef Peters RM, Claessen FM, Doornberg JN, Kolovich GP, Diercks RL, van den Bekerom MP. Union rate after operative treatment of humeral shaft nonunion–A systematic review. Injury. 2015;46(12):2314–24.PubMedCrossRef
3.
go back to reference Badman BL, Mighell M, Kalandiak SP, Prasarn M. Proximal humeral nonunions treated with fixed-angle locked plating and an intramedullary strut allograft. J Orthop Trauma. 2009;23(3):173–9.PubMedCrossRef Badman BL, Mighell M, Kalandiak SP, Prasarn M. Proximal humeral nonunions treated with fixed-angle locked plating and an intramedullary strut allograft. J Orthop Trauma. 2009;23(3):173–9.PubMedCrossRef
4.
go back to reference Wichlas F, Tsitsilonis S, Disch AC, et al. Long-term functional outcome and quality of life after successful surgical treatment of tibial nonunions. Int Orthop. 2015;39(3):521–5.PubMedCrossRef Wichlas F, Tsitsilonis S, Disch AC, et al. Long-term functional outcome and quality of life after successful surgical treatment of tibial nonunions. Int Orthop. 2015;39(3):521–5.PubMedCrossRef
5.
go back to reference Schottel PC, O’Connor DP, Brinker MR. Time Trade-Off as a Measure of Health-Related Quality of Life: Long Bone Nonunions Have a Devastating Impact. J Bone Joint Surg Am. 2015;97(17):1406–10.PubMedCrossRef Schottel PC, O’Connor DP, Brinker MR. Time Trade-Off as a Measure of Health-Related Quality of Life: Long Bone Nonunions Have a Devastating Impact. J Bone Joint Surg Am. 2015;97(17):1406–10.PubMedCrossRef
6.
go back to reference Tay WH, de Steiger R, Richardson M, Gruen R, Balogh ZJ. Health outcomes of delayed union and nonunion of femoral and tibial shaft fractures. Injury. 2014;45(10):1653–8.PubMedCrossRef Tay WH, de Steiger R, Richardson M, Gruen R, Balogh ZJ. Health outcomes of delayed union and nonunion of femoral and tibial shaft fractures. Injury. 2014;45(10):1653–8.PubMedCrossRef
7.
go back to reference Liu C, Zhang X, Zhang X, Li Z, Xu Y, Liu T. Bone transport with a unilateral external fixator for femoral infected nonunion after intramedullary nailing fixation: A case control study. Medicine(Baltimore). 2019;98(20):e15612. Liu C, Zhang X, Zhang X, Li Z, Xu Y, Liu T. Bone transport with a unilateral external fixator for femoral infected nonunion after intramedullary nailing fixation: A case control study. Medicine(Baltimore). 2019;98(20):e15612.
8.
go back to reference Atalar AC, Kocaoglu M, Demirhan M, Bilsel K, Eralp L. Comparison of three different treatment modalities in the management of humeral shaft nonunions (plates, unilateral, and circular external fixators). J Orthop Trauma. 2008;22(4):248–57.PubMedCrossRef Atalar AC, Kocaoglu M, Demirhan M, Bilsel K, Eralp L. Comparison of three different treatment modalities in the management of humeral shaft nonunions (plates, unilateral, and circular external fixators). J Orthop Trauma. 2008;22(4):248–57.PubMedCrossRef
9.
go back to reference Sun L, Li Z, Ma T, et al. Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients. J Int Med Res. 2019;47(5):1998–2010.PubMedPubMedCentralCrossRef Sun L, Li Z, Ma T, et al. Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients. J Int Med Res. 2019;47(5):1998–2010.PubMedPubMedCentralCrossRef
10.
go back to reference Lerner RK, Esterhai JL Jr, Polomano RC, Cheatle MD, Heppenstall RB. Quality of life assessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower-extremity amputation. Clin Orthop Relat Res. 1993(295):28–36. Lerner RK, Esterhai JL Jr, Polomano RC, Cheatle MD, Heppenstall RB. Quality of life assessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower-extremity amputation. Clin Orthop Relat Res. 1993(295):28–36.
11.
go back to reference Haverstock BD, Mandracchia VJ. Cigarette smoking and bone healing: implications in foot and ankle surgery. J Foot Ankle Surg. 1998;37(1):69–78.PubMedCrossRef Haverstock BD, Mandracchia VJ. Cigarette smoking and bone healing: implications in foot and ankle surgery. J Foot Ankle Surg. 1998;37(1):69–78.PubMedCrossRef
12.
go back to reference Toro G, Lepore F, Calabrò G, et al. Humeral shaft non-union in the elderly: Results with cortical graft plus stem cells. Injury. 2019;50(Suppl 2):75-s79. Toro G, Lepore F, Calabrò G, et al. Humeral shaft non-union in the elderly: Results with cortical graft plus stem cells. Injury. 2019;50(Suppl 2):75-s79.
13.
go back to reference van de Wall BJM, Ganzert C, Theus C, et al. Results of plate fixation for humerus fractures in a large single-center cohort. Arch Orthop Trauma Surg. 2020;140(10):1311–8.PubMedCrossRef van de Wall BJM, Ganzert C, Theus C, et al. Results of plate fixation for humerus fractures in a large single-center cohort. Arch Orthop Trauma Surg. 2020;140(10):1311–8.PubMedCrossRef
14.
go back to reference Dailey HL, Wu KA, Wu PS, McQueen MM, Court-Brown CM. Tibial Fracture Nonunion and Time to Healing After Reamed Intramedullary Nailing: Risk Factors Based on a Single-Center Review of 1003 Patients. J Orthop Trauma. 2018;32(7):e263-9.PubMedCrossRef Dailey HL, Wu KA, Wu PS, McQueen MM, Court-Brown CM. Tibial Fracture Nonunion and Time to Healing After Reamed Intramedullary Nailing: Risk Factors Based on a Single-Center Review of 1003 Patients. J Orthop Trauma. 2018;32(7):e263-9.PubMedCrossRef
15.
go back to reference Nauth A, Lee M, Gardner MJ, et al. Principles of Nonunion Management: State of the Art. J Orthop Trauma. 2018;32(Suppl 1):52-s57. Nauth A, Lee M, Gardner MJ, et al. Principles of Nonunion Management: State of the Art. J Orthop Trauma. 2018;32(Suppl 1):52-s57.
16.
go back to reference Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg AM. 2014;39(6):1146–50.PubMedCrossRef Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg AM. 2014;39(6):1146–50.PubMedCrossRef
17.
go back to reference Luo N, Wang P, Fu AZ, Johnson JA, Coons SJ. Preference-based SF-6D scores derived from the SF-36 and SF-12 have different discriminative power in a population health survey. Med Care. 2012;50(7):627–32.PubMedCrossRef Luo N, Wang P, Fu AZ, Johnson JA, Coons SJ. Preference-based SF-6D scores derived from the SF-36 and SF-12 have different discriminative power in a population health survey. Med Care. 2012;50(7):627–32.PubMedCrossRef
18.
go back to reference Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC. Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain. 1996;67(2–3):267–73.PubMedCrossRef Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC. Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain. 1996;67(2–3):267–73.PubMedCrossRef
19.
go back to reference Chan SF, Ho SM, Poon KW, Ip A, Cheung OY. Pilot assessment of pain of orthopaedic patients in Hong Kong. Psychol Rep. 2005;96(2):527–32.PubMedCrossRef Chan SF, Ho SM, Poon KW, Ip A, Cheung OY. Pilot assessment of pain of orthopaedic patients in Hong Kong. Psychol Rep. 2005;96(2):527–32.PubMedCrossRef
20.
go back to reference Huang Q, Zhou ZK, Shen B, et al. Validation of the SF-12 among adult Kashin-Beck disease patients in Aba Tibetan autonomous area in China. Rheumatol Int. 2013;33(3):719–24.PubMedCrossRef Huang Q, Zhou ZK, Shen B, et al. Validation of the SF-12 among adult Kashin-Beck disease patients in Aba Tibetan autonomous area in China. Rheumatol Int. 2013;33(3):719–24.PubMedCrossRef
21.
go back to reference Wong CK, Lo YY, Wong WH, Fung CS. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life outcomes. 2013;11:142.PubMedPubMedCentralCrossRef Wong CK, Lo YY, Wong WH, Fung CS. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life outcomes. 2013;11:142.PubMedPubMedCentralCrossRef
22.
go back to reference Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS. Apathy and health-related quality of life in stroke. Arch Phys Med Rehabil. 2014;95(5):857–61.PubMedCrossRef Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS. Apathy and health-related quality of life in stroke. Arch Phys Med Rehabil. 2014;95(5):857–61.PubMedCrossRef
23.
go back to reference Si T, Wang G, Yang F, et al. Efficacy and safety of escitalopram in treatment of severe depression in Chinese population. Metab Brain Dis. 2017;32(3):891–901.PubMedCrossRef Si T, Wang G, Yang F, et al. Efficacy and safety of escitalopram in treatment of severe depression in Chinese population. Metab Brain Dis. 2017;32(3):891–901.PubMedCrossRef
24.
go back to reference Lee SW, Lien HC, Chang CS, Ko CW, Tung CF, Yeh HZ. Health-related quality of life of subjects with Barrett’s esophagus in a Chinese population. PloS one. 2017;12(12):e0190201.PubMedPubMedCentralCrossRef Lee SW, Lien HC, Chang CS, Ko CW, Tung CF, Yeh HZ. Health-related quality of life of subjects with Barrett’s esophagus in a Chinese population. PloS one. 2017;12(12):e0190201.PubMedPubMedCentralCrossRef
25.
go back to reference Wang Y, Fan S, Wang H, Li L, Jia Y, Chai L. Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2): an effective tool to assess perceived burden of thyroid cancer in mainland China. Support Care Cancer. 2018;26(9):3267–75.PubMedPubMedCentralCrossRef Wang Y, Fan S, Wang H, Li L, Jia Y, Chai L. Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2): an effective tool to assess perceived burden of thyroid cancer in mainland China. Support Care Cancer. 2018;26(9):3267–75.PubMedPubMedCentralCrossRef
26.
go back to reference Li Q, Xu Y, Zhou H, Loke AY. Factors influencing the health-related quality of life of Chinese advanced cancer patients and their spousal caregivers: a cross-sectional study. BMC Palliat Care. 2016;15:72.PubMedPubMedCentralCrossRef Li Q, Xu Y, Zhou H, Loke AY. Factors influencing the health-related quality of life of Chinese advanced cancer patients and their spousal caregivers: a cross-sectional study. BMC Palliat Care. 2016;15:72.PubMedPubMedCentralCrossRef
27.
go back to reference Choi EP, Wong CK, Wan EY, et al. The internal and external responsiveness of Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Short Form-12 Health Survey version 2 (SF-12 v2) in patients with prostate cancer. Qual Life Res. 2016;25(9):2379–93.PubMedCrossRef Choi EP, Wong CK, Wan EY, et al. The internal and external responsiveness of Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Short Form-12 Health Survey version 2 (SF-12 v2) in patients with prostate cancer. Qual Life Res. 2016;25(9):2379–93.PubMedCrossRef
28.
go back to reference Yao XI, Ni MY, Cheung F, et al. Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts. CMAJ. 2019;191(27):E753-60.PubMedPubMedCentralCrossRef Yao XI, Ni MY, Cheung F, et al. Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts. CMAJ. 2019;191(27):E753-60.PubMedPubMedCentralCrossRef
29.
go back to reference Wan EYF, Yu EYT, Chin WY, Choi EPH, Wu T, Lam CLK. Evaluation of the responsiveness of Short Form-12 Health Survey version 2 (SF-12v2) in Chinese patients with hypertension in primary care. Qual Life Res. 2019;28(10):2851–7.PubMedCrossRef Wan EYF, Yu EYT, Chin WY, Choi EPH, Wu T, Lam CLK. Evaluation of the responsiveness of Short Form-12 Health Survey version 2 (SF-12v2) in Chinese patients with hypertension in primary care. Qual Life Res. 2019;28(10):2851–7.PubMedCrossRef
30.
go back to reference Hu Z, Man GCW, Kwok AKL, et al. Global sagittal alignment in elderly patients with osteoporosis and its relationship with severity of vertebral fracture and quality of life. Arch Osteoporos. 2018;13(1):95.PubMedCrossRef Hu Z, Man GCW, Kwok AKL, et al. Global sagittal alignment in elderly patients with osteoporosis and its relationship with severity of vertebral fracture and quality of life. Arch Osteoporos. 2018;13(1):95.PubMedCrossRef
31.
go back to reference Wong CKH, Chen JY, Fung SKS, et al. Health-related quality of life and health utility of Chinese patients undergoing nocturnal home haemodialysis in comparison with other modes of dialysis. Nephrology (Carlton). 2019;24(6):630–7.CrossRef Wong CKH, Chen JY, Fung SKS, et al. Health-related quality of life and health utility of Chinese patients undergoing nocturnal home haemodialysis in comparison with other modes of dialysis. Nephrology (Carlton). 2019;24(6):630–7.CrossRef
32.
go back to reference Gao B, Yang S, Liu X, Ren X, Liu D, Li N. Association between social capital and quality of life among urban residents in less developed cities of western China: A cross-sectional study. Medicine(Baltimore). 2018;97(4):e9656. Gao B, Yang S, Liu X, Ren X, Liu D, Li N. Association between social capital and quality of life among urban residents in less developed cities of western China: A cross-sectional study. Medicine(Baltimore). 2018;97(4):e9656.
33.
go back to reference Guo VY, Yu EYT, Wong RSM, et al. Maternal mental quality of life mediates the associations between intimate partner abuse against mothers and their children’s behaviours and quality of life in low-income Chinese families. Qual Life Res. 2017;26(12):3297–306.PubMedCrossRef Guo VY, Yu EYT, Wong RSM, et al. Maternal mental quality of life mediates the associations between intimate partner abuse against mothers and their children’s behaviours and quality of life in low-income Chinese families. Qual Life Res. 2017;26(12):3297–306.PubMedCrossRef
34.
go back to reference Choi EP, Lam CL, Chin WY. Mental Health Mediating the Relationship Between Symptom Severity and Health-Related Quality of Life in Patients with Lower Urinary Tract Symptoms. Low Urin Tract symptoms. 2016;8(3):141–9.PubMedCrossRef Choi EP, Lam CL, Chin WY. Mental Health Mediating the Relationship Between Symptom Severity and Health-Related Quality of Life in Patients with Lower Urinary Tract Symptoms. Low Urin Tract symptoms. 2016;8(3):141–9.PubMedCrossRef
35.
go back to reference Xiang YT, Wong TS, Tsoh J, et al. Quality of life in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study. Perspect Psychiatr Care. 2015;51(2):121–7.PubMedCrossRef Xiang YT, Wong TS, Tsoh J, et al. Quality of life in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study. Perspect Psychiatr Care. 2015;51(2):121–7.PubMedCrossRef
36.
go back to reference Brinker MR, Trivedi A, OʼConnor DP. Debilitating Effects of Femoral Nonunion on Health-Related Quality of Life. J Orthop Trauma. 2017;31(2):e37-42.PubMedCrossRef Brinker MR, Trivedi A, OʼConnor DP. Debilitating Effects of Femoral Nonunion on Health-Related Quality of Life. J Orthop Trauma. 2017;31(2):e37-42.PubMedCrossRef
37.
go back to reference Lee PH, Wong FK, Wang SL, Chow SK. Substitution of SF-36 by SF-12 Among Hong Kong Chinese Older Adults: Secondary Analysis of Randomized Controlled Trials. Int J Behav Med. 2016;23(5):635–44.PubMedCrossRef Lee PH, Wong FK, Wang SL, Chow SK. Substitution of SF-36 by SF-12 Among Hong Kong Chinese Older Adults: Secondary Analysis of Randomized Controlled Trials. Int J Behav Med. 2016;23(5):635–44.PubMedCrossRef
38.
go back to reference Wang XS, Mendoza TR, Gao SZ, Cleeland CS. The Chinese version of the Brief Pain Inventory (BPI-C): its development and use in a study of cancer pain. Pain. 1996;67(2–3):407–16.PubMedCrossRef Wang XS, Mendoza TR, Gao SZ, Cleeland CS. The Chinese version of the Brief Pain Inventory (BPI-C): its development and use in a study of cancer pain. Pain. 1996;67(2–3):407–16.PubMedCrossRef
39.
go back to reference Bhandari M, Busse JW, Hanson BP, Leece P, Ayeni OR, Schemitsch EH. Psychological distress and quality of life after orthopedic trauma: an observational study. Can J Surg. 2008;51(1):15–22.PubMedPubMedCentral Bhandari M, Busse JW, Hanson BP, Leece P, Ayeni OR, Schemitsch EH. Psychological distress and quality of life after orthopedic trauma: an observational study. Can J Surg. 2008;51(1):15–22.PubMedPubMedCentral
40.
go back to reference Ioannou LJ, Cameron PA, Gibson SJ, et al. Traumatic injury and perceived injustice: Fault attributions matter in a “no-fault” compensation state. PloS one. 2017;12(6):e0178894.PubMedPubMedCentralCrossRef Ioannou LJ, Cameron PA, Gibson SJ, et al. Traumatic injury and perceived injustice: Fault attributions matter in a “no-fault” compensation state. PloS one. 2017;12(6):e0178894.PubMedPubMedCentralCrossRef
41.
go back to reference Brinker MR, Hanus BD, Sen M, O’Connor DP. The devastating effects of tibial nonunion on health-related quality of life. J Bone Joint Surg Am. 2013;95(24):2170–6.PubMedCrossRef Brinker MR, Hanus BD, Sen M, O’Connor DP. The devastating effects of tibial nonunion on health-related quality of life. J Bone Joint Surg Am. 2013;95(24):2170–6.PubMedCrossRef
42.
go back to reference Johnson L, Igoe E, Kleftouris G, Papachristos IV, Papakostidis C, Giannoudis PV. Physical Health and Psychological Outcomes in Adult Patients with Long-bone Fracture Non-unions: Evidence Today. J Clin Med. 2019;8(11):1998.PubMedCentralCrossRef Johnson L, Igoe E, Kleftouris G, Papachristos IV, Papakostidis C, Giannoudis PV. Physical Health and Psychological Outcomes in Adult Patients with Long-bone Fracture Non-unions: Evidence Today. J Clin Med. 2019;8(11):1998.PubMedCentralCrossRef
Metadata
Title
Do the successful revision surgery for humeral nonunion solve all the effects on health‐related quality of life? A retrospective cohort study
Authors
Zhimeng Wang
Yao Lu
Liang Sun
Leilei Song
Teng Ma
Qiang Wang
Kun Zhang
Zhong Li
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-021-04283-9

Other articles of this Issue 1/2021

BMC Musculoskeletal Disorders 1/2021 Go to the issue