Chiara Concina - Academia.edu (original) (raw)

Papers by Chiara Concina

Acta Bio Medica : Atenei Parmensis, 2021

Background and aim: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing an... more Background and aim: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated to high risk of complications, due to elderly population and associated comorbidities. We retrospectively assessed 79 patients at 1- to 8-years follow-up, focusing on factors that may have affected results and complications. Methods: Seventy-nine PPFFs were classified according to Vancouver classification in: 4 type B1, 22 type B2, 29 type B3, 24 type C. The average age of the patients was 81.5 year-old (61-95). 37 PPFFs (12 type B2 and 25 type B3) were treated with uncemented tapered fluted revision stems (Link MP Recostruction Stem, Waldermar Link GmbH) and 42 patients with open reduction and internal fixation (ORIF). Patients were clinically and radiographically assessed at a mean 5-year follow-up (1-8 years). Elixhauser Comorbidity index was analysed. Results: All PPFFs, except two, healed within 10 months. Harris Hip score at follow-up was 6...

Acta Bio Medica : Atenei Parmensis, 2019

Background: Fast track in total knee replacement (TKR) is a widely used protocol. Tranexamic acid... more Background: Fast track in total knee replacement (TKR) is a widely used protocol. Tranexamic acid proved to be effective in reducing perioperative bleeding without increasing thromboembolic risk. The aim of this study was to assess if tourniquet and suction drainage might affect perioperative blood loss and post-operative functional recovery after TKR. Methods: 151 patients, who underwent to TKR, were assessed and divided into three homogeneous groups: group A (51 patients) in which both tourniquet and suction drainage have been applied (tourniquet has been release before wound closure); group B (50 patients) in which neither tourniquet nor suction drainage have been used; group C (50 patients) in which only tourniquet has been used. Perioperative intravenous tranexamic acid and post-operative low-molecular-weight heparin have been administered. Trend of haemoglobin values, transfusion rate, pain, ability to obtain 90 degrees of flexion and length of stay were analysed. Results: The...

Acta Bio Medica : Atenei Parmensis, 2020

Background and aim: Trapezial-metacarpal arthritis (TMA) is a common and highly disabling patholo... more Background and aim: Trapezial-metacarpal arthritis (TMA) is a common and highly disabling pathology. Trapeziectomy and Ceruso’s suspensionplasty is described for moderate-severe stages. The aim of the present study was to assess functional and radiographic results at an average 5-year follow-up using a modified Ceruso’s technique where the Abductor Pollicis Longus (APL) is passed twice around the Flexor Carpi Radialis (FCR) and a suture mini-anchor in the base of the first metacarpal is used to further stabilize the thumb. Methods: 85 consecutive modified Ceruso’s suspensionplasty were performed from 2012 and 2018. All patients were evaluated at an average 5.1-year follow-up (21-96 months). Subjective patient satisfaction rate, NRS, DASH score, abduction angle, Kapandji score and pinch strength using functional tests were assessed. The scapho-metacarpal distance was measured at follow-up radiographs. Results: 90.6% of the patients were satisfied by the treatment. The NRS and the DAS...

Acta Bio Medica : Atenei Parmensis, 2019

Despite the advantages of modular total hip arthroplasty in terms of neck version, offset and len... more Despite the advantages of modular total hip arthroplasty in terms of neck version, offset and length precise reproduction, titanium necks breakage became a concern. Consequently, titanium has been replaced by cobalt-chrome (Co-Cr). However, four cases of Co-Cr modular neck breakage have been reported in the literature. In the present paper, two cases of Co-Cr modular neck fractures are described together with a literature review. The aim of this work is to discuss the risk factors and characteristics of this rare complication. We described two cases of fracture of long varus Co-Cr modular femoral neck connected with cementless press-fit stem. Some risk factors, such as long varus type of modular neck, overweight and/or high demanding physical activity, might have contributed to implant failure. (www.actabiomedica.it)

Revue de Chirurgie Orthopédique et Traumatologique, 2015

90 e réunion annuelle de la Société franç aise de chirurgie orthopédique et traumatologique / Rev... more 90 e réunion annuelle de la Société franç aise de chirurgie orthopédique et traumatologique / Revue de chirurgie orthopédique et traumatologique 101S (2015) S138-S258 S145 à la rotation externe lors de leur insertion, ce qui peut modifier leur antéversion. La correction de cette rotation externe imposée par le plan de la courbure diaphysaire pour éviter une antéversion excessive peut entraîner de ce fait un pressfit moins satisfaisant. Les tiges modulaires permettent une adaptation mais au prix d'un risque de fracture de l'implant. Les tiges longues monobloc avec courbure diaphysaire n'ont pas ces inconvénients mais leur mise en place doit tenir compte de ces données anatomiques. Déclaration d'intérêts Les auteurs déclarent avoir des conflits d'intérêts en relation avec cet article (bénéfice d'un des auteurs directement par une firme), (bénéfice d'un des auteurs par une firme par l'intermédiaire d'une association), (versement par une firme à une association) (bénéfice pour les auteurs).

Arthroscopy Techniques, 2014

Posterior shoulder instability is far less common than anterior instability, and its arthroscopic... more Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head.

Open Journal of Orthopedics, 2014

Introduction: Analgesia following shoulder surgery commonly uses interscalene nerve blockade. Whe... more Introduction: Analgesia following shoulder surgery commonly uses interscalene nerve blockade. When contraindicated (i.e. respiratory compromise), suprascapular nerve blockade can provide a viable alternative. Although a number of techniques have been used, Barber in 2005 described a simple method using anatomical landmarks. While theoretically straightforward, substantive evidence supporting the advantages attributed to the technique has yet to be identified. The present study anatomically examines the technique proposed by Barber to critically assess its potential to benefit clinical practice. Materials and Methods: Using the technique proposed by Barber in 2005, the Nevaiser portal was used to introduce a K-wire into the supraspinous fossa in the region of the suprascapular nerve. A spinal needle was inserted in the same manner and left in position in the presumed region of the transverse scapular ligament. Tissue was dissected out around the wire and needle to visualize their proximity to the suprascapular nerve and transverse scapular ligament respectively. Results: The K-wire was consistently located close to the suprascapular nerve with all cases being within 5 mm. Spinal needle placement relative to the transverse scapular ligament was variable with 50% anterior, 25% posterior, and 25% displaced (likely due to dissection). Conclusions: The results illustrate that it is possible to reliably place a needle close to the suprascapular nerve using the technique described by Barber in 2005. This study provides anatomical confirmation of Barbers description of a simple technique and the basis for clinical study.

Revue de Chirurgie Orthopédique et Traumatologique, 2013

Introduction.-La survie d'une prothèse totale de hanche dépend principalement de la qualité de po... more Introduction.-La survie d'une prothèse totale de hanche dépend principalement de la qualité de pose des implants. Classiquement, elle est le fruit du savoir-faire et de l'expérience du chirurgien. Aujourd'hui, des systèmes de navigation sont à sa disposition pour faciliter ce bon positionnement. Par ailleurs, les abords miniinvasifs n'ont pas fait la preuve de leur supériorité en termes de résultats cliniques et génèrent parfois des complications de type malposition. Le but de ce travail est d'évaluer une technique combinant mini-abord et navigation. Patients et méthode.-Il s'agit d'une série prospective, continue, mono-opérateur, de patients opérés d'une arthroplastie totale de hanche par voie de Hardinge mini-invasive assistée par un système de navigation (orthopilot ®). Les implants étaient tous non cimentés, avec un couple céramique/céramique et des têtes de 28 à 36. Le recul minimal était de 1 an, le recul maximal moyen de 3 ans. L'évolution clinique, les complications per-et postopératoires ainsi que le positionnement des implants ont été analysés. Deux cent quatorze patients ont été inclus, 94 hommes et 120 femmes d'âge moyen 65,9 ans (22,6-89,2). Résultats.-Le score HHS moyen postopératoire était de 93,3 ± 5,6 (76-100) contre 47,8 ± 10,6 (13-81) en préopératoire. Le taux de complications global était de 9,3 % : 1,4 % de fracture peropératoire, 1,8 % de luxation après la première révision et 1,4 % d'enfoncement symptomatique. Dans 95,4 % des cas, l'inclinaison du cotyle était idéale (40 •-50 •) et l'antéversion l'était également dans 96,8 % des cas. Aucun rapport significatif n'a pu être mis en évidence entre la survenue d'une complication et l'IMC du patient. Le système de navigation a par ailleurs permis de corriger 9 inégalités de longueur sur 14 préopératoire. Discussion.-Dans cette série, la chirurgie mini-invasive n'est pas source de complications spécifiques. De plus, grâce à la navigation, l'objectif de positionnement a été atteint. La navigation nous semble un complément indispensable à la chirurgie mini-invasive car elle sécurise le geste en évitant une malposition liée aux contraintes de dissection. Conclusion.-Les résultats de cette série sont en accord avec ceux de la littérature utilisant un abord classique. Couplée à la navigation, la voie de Hardinge mini-invasive permet un positionnement correct et reproductible des implants.

Gait & Posture, 2009

ankle natural mobility while maintaining full conformity, achieved by a backward and forward moti... more ankle natural mobility while maintaining full conformity, achieved by a backward and forward motion of the meniscal bearing throughout the flexion arc. In this study the expected early functional recovery was evaluated by a clinical scoring system and by gait analysis performed at 6 and 12 months from surgery. Methods: Thirteen patients operated with the BOX Ankle (Finsbury Orthopaedics, UK), with mean age 56.3 years (range 44-71), BMI 25.2 (range 20.4-34.1), 9 males and 4 females, 11 post traumatic ostheo-, 1 psoriasic and 1 rheumatoid arthritis were gait analysed preoperatively and at 6 and 12 month follow-up. The examination consisted in a clinical score (AOFAS) and in gait analysis (Vicon 612 System, Oxford, UK, Kistler forceplates) adopting a recently validated protocol [2]. Results were compared with a 'control group' of 20 subjects, with mean age 27.9 years (range 23-36), BMI 21.9 (range 18.5-25), 11 male and 9 females. Results: AOFAS score rose from 39.9 in pre-op to 81.4 at 12 months, with a considerable reduction of pain (score from 13.1 to 31.5, max 40), and improvement of ankle alignment (from 5.4 to 9.1, max 10) and function (from 21.4 to 40.8, max 50). Spatiotemporal parameters obtained with gait analysis showed a good recovery at 6 months and a successive settlement on the operated site: i.e. mean stride length normalised (81.9, % of height, for control group) was 63.0 pre-op, 70.5 at 6 months and 71.0 at 12 months; speed (127.8 cm/s for control group) rose from 79.2 to 100.8 cm/s at 6 months and 102.7 cm/s at 12 months. Ankle joint rotation range improved in all three anatomical planes at 6 months, somehow maintained at 12 months; in particular in the sagittal, there was an increase of max dorsi-flexion in the stance phase (2.58 pre-op, 5.48 and 6.28 at 6 and 12 months), though a persistent limited plantar-flexion at initial contact and a moderate reduction of plantar-flexion during swing were observed at. Plantar-flexion moment showed a smoother pattern after surgery (Fig. 1). Discussion: The novel ankle prosthesis seems to contribute to an early functional recovery at 6 months maintained at one year. Preliminary assessments at 24 months confirmed the improvements achieved at 12 months. With reduction of pain and recovery of joint control, the gait variables of high clinical interest, such as stance balance and ability in propulsion, improve.

Clinics in Shoulder and Elbow, 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the... more We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complicat...

Acta Bio Medica : Atenei Parmensis, 2021

Background and aim: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing an... more Background and aim: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated to high risk of complications, due to elderly population and associated comorbidities. We retrospectively assessed 79 patients at 1- to 8-years follow-up, focusing on factors that may have affected results and complications. Methods: Seventy-nine PPFFs were classified according to Vancouver classification in: 4 type B1, 22 type B2, 29 type B3, 24 type C. The average age of the patients was 81.5 year-old (61-95). 37 PPFFs (12 type B2 and 25 type B3) were treated with uncemented tapered fluted revision stems (Link MP Recostruction Stem, Waldermar Link GmbH) and 42 patients with open reduction and internal fixation (ORIF). Patients were clinically and radiographically assessed at a mean 5-year follow-up (1-8 years). Elixhauser Comorbidity index was analysed. Results: All PPFFs, except two, healed within 10 months. Harris Hip score at follow-up was 6...

Acta Bio Medica : Atenei Parmensis, 2019

Background: Fast track in total knee replacement (TKR) is a widely used protocol. Tranexamic acid... more Background: Fast track in total knee replacement (TKR) is a widely used protocol. Tranexamic acid proved to be effective in reducing perioperative bleeding without increasing thromboembolic risk. The aim of this study was to assess if tourniquet and suction drainage might affect perioperative blood loss and post-operative functional recovery after TKR. Methods: 151 patients, who underwent to TKR, were assessed and divided into three homogeneous groups: group A (51 patients) in which both tourniquet and suction drainage have been applied (tourniquet has been release before wound closure); group B (50 patients) in which neither tourniquet nor suction drainage have been used; group C (50 patients) in which only tourniquet has been used. Perioperative intravenous tranexamic acid and post-operative low-molecular-weight heparin have been administered. Trend of haemoglobin values, transfusion rate, pain, ability to obtain 90 degrees of flexion and length of stay were analysed. Results: The...

Acta Bio Medica : Atenei Parmensis, 2020

Background and aim: Trapezial-metacarpal arthritis (TMA) is a common and highly disabling patholo... more Background and aim: Trapezial-metacarpal arthritis (TMA) is a common and highly disabling pathology. Trapeziectomy and Ceruso’s suspensionplasty is described for moderate-severe stages. The aim of the present study was to assess functional and radiographic results at an average 5-year follow-up using a modified Ceruso’s technique where the Abductor Pollicis Longus (APL) is passed twice around the Flexor Carpi Radialis (FCR) and a suture mini-anchor in the base of the first metacarpal is used to further stabilize the thumb. Methods: 85 consecutive modified Ceruso’s suspensionplasty were performed from 2012 and 2018. All patients were evaluated at an average 5.1-year follow-up (21-96 months). Subjective patient satisfaction rate, NRS, DASH score, abduction angle, Kapandji score and pinch strength using functional tests were assessed. The scapho-metacarpal distance was measured at follow-up radiographs. Results: 90.6% of the patients were satisfied by the treatment. The NRS and the DAS...

Acta Bio Medica : Atenei Parmensis, 2019

Despite the advantages of modular total hip arthroplasty in terms of neck version, offset and len... more Despite the advantages of modular total hip arthroplasty in terms of neck version, offset and length precise reproduction, titanium necks breakage became a concern. Consequently, titanium has been replaced by cobalt-chrome (Co-Cr). However, four cases of Co-Cr modular neck breakage have been reported in the literature. In the present paper, two cases of Co-Cr modular neck fractures are described together with a literature review. The aim of this work is to discuss the risk factors and characteristics of this rare complication. We described two cases of fracture of long varus Co-Cr modular femoral neck connected with cementless press-fit stem. Some risk factors, such as long varus type of modular neck, overweight and/or high demanding physical activity, might have contributed to implant failure. (www.actabiomedica.it)

Revue de Chirurgie Orthopédique et Traumatologique, 2015

90 e réunion annuelle de la Société franç aise de chirurgie orthopédique et traumatologique / Rev... more 90 e réunion annuelle de la Société franç aise de chirurgie orthopédique et traumatologique / Revue de chirurgie orthopédique et traumatologique 101S (2015) S138-S258 S145 à la rotation externe lors de leur insertion, ce qui peut modifier leur antéversion. La correction de cette rotation externe imposée par le plan de la courbure diaphysaire pour éviter une antéversion excessive peut entraîner de ce fait un pressfit moins satisfaisant. Les tiges modulaires permettent une adaptation mais au prix d'un risque de fracture de l'implant. Les tiges longues monobloc avec courbure diaphysaire n'ont pas ces inconvénients mais leur mise en place doit tenir compte de ces données anatomiques. Déclaration d'intérêts Les auteurs déclarent avoir des conflits d'intérêts en relation avec cet article (bénéfice d'un des auteurs directement par une firme), (bénéfice d'un des auteurs par une firme par l'intermédiaire d'une association), (versement par une firme à une association) (bénéfice pour les auteurs).

Arthroscopy Techniques, 2014

Posterior shoulder instability is far less common than anterior instability, and its arthroscopic... more Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head.

Open Journal of Orthopedics, 2014

Introduction: Analgesia following shoulder surgery commonly uses interscalene nerve blockade. Whe... more Introduction: Analgesia following shoulder surgery commonly uses interscalene nerve blockade. When contraindicated (i.e. respiratory compromise), suprascapular nerve blockade can provide a viable alternative. Although a number of techniques have been used, Barber in 2005 described a simple method using anatomical landmarks. While theoretically straightforward, substantive evidence supporting the advantages attributed to the technique has yet to be identified. The present study anatomically examines the technique proposed by Barber to critically assess its potential to benefit clinical practice. Materials and Methods: Using the technique proposed by Barber in 2005, the Nevaiser portal was used to introduce a K-wire into the supraspinous fossa in the region of the suprascapular nerve. A spinal needle was inserted in the same manner and left in position in the presumed region of the transverse scapular ligament. Tissue was dissected out around the wire and needle to visualize their proximity to the suprascapular nerve and transverse scapular ligament respectively. Results: The K-wire was consistently located close to the suprascapular nerve with all cases being within 5 mm. Spinal needle placement relative to the transverse scapular ligament was variable with 50% anterior, 25% posterior, and 25% displaced (likely due to dissection). Conclusions: The results illustrate that it is possible to reliably place a needle close to the suprascapular nerve using the technique described by Barber in 2005. This study provides anatomical confirmation of Barbers description of a simple technique and the basis for clinical study.

Revue de Chirurgie Orthopédique et Traumatologique, 2013

Introduction.-La survie d'une prothèse totale de hanche dépend principalement de la qualité de po... more Introduction.-La survie d'une prothèse totale de hanche dépend principalement de la qualité de pose des implants. Classiquement, elle est le fruit du savoir-faire et de l'expérience du chirurgien. Aujourd'hui, des systèmes de navigation sont à sa disposition pour faciliter ce bon positionnement. Par ailleurs, les abords miniinvasifs n'ont pas fait la preuve de leur supériorité en termes de résultats cliniques et génèrent parfois des complications de type malposition. Le but de ce travail est d'évaluer une technique combinant mini-abord et navigation. Patients et méthode.-Il s'agit d'une série prospective, continue, mono-opérateur, de patients opérés d'une arthroplastie totale de hanche par voie de Hardinge mini-invasive assistée par un système de navigation (orthopilot ®). Les implants étaient tous non cimentés, avec un couple céramique/céramique et des têtes de 28 à 36. Le recul minimal était de 1 an, le recul maximal moyen de 3 ans. L'évolution clinique, les complications per-et postopératoires ainsi que le positionnement des implants ont été analysés. Deux cent quatorze patients ont été inclus, 94 hommes et 120 femmes d'âge moyen 65,9 ans (22,6-89,2). Résultats.-Le score HHS moyen postopératoire était de 93,3 ± 5,6 (76-100) contre 47,8 ± 10,6 (13-81) en préopératoire. Le taux de complications global était de 9,3 % : 1,4 % de fracture peropératoire, 1,8 % de luxation après la première révision et 1,4 % d'enfoncement symptomatique. Dans 95,4 % des cas, l'inclinaison du cotyle était idéale (40 •-50 •) et l'antéversion l'était également dans 96,8 % des cas. Aucun rapport significatif n'a pu être mis en évidence entre la survenue d'une complication et l'IMC du patient. Le système de navigation a par ailleurs permis de corriger 9 inégalités de longueur sur 14 préopératoire. Discussion.-Dans cette série, la chirurgie mini-invasive n'est pas source de complications spécifiques. De plus, grâce à la navigation, l'objectif de positionnement a été atteint. La navigation nous semble un complément indispensable à la chirurgie mini-invasive car elle sécurise le geste en évitant une malposition liée aux contraintes de dissection. Conclusion.-Les résultats de cette série sont en accord avec ceux de la littérature utilisant un abord classique. Couplée à la navigation, la voie de Hardinge mini-invasive permet un positionnement correct et reproductible des implants.

Gait & Posture, 2009

ankle natural mobility while maintaining full conformity, achieved by a backward and forward moti... more ankle natural mobility while maintaining full conformity, achieved by a backward and forward motion of the meniscal bearing throughout the flexion arc. In this study the expected early functional recovery was evaluated by a clinical scoring system and by gait analysis performed at 6 and 12 months from surgery. Methods: Thirteen patients operated with the BOX Ankle (Finsbury Orthopaedics, UK), with mean age 56.3 years (range 44-71), BMI 25.2 (range 20.4-34.1), 9 males and 4 females, 11 post traumatic ostheo-, 1 psoriasic and 1 rheumatoid arthritis were gait analysed preoperatively and at 6 and 12 month follow-up. The examination consisted in a clinical score (AOFAS) and in gait analysis (Vicon 612 System, Oxford, UK, Kistler forceplates) adopting a recently validated protocol [2]. Results were compared with a 'control group' of 20 subjects, with mean age 27.9 years (range 23-36), BMI 21.9 (range 18.5-25), 11 male and 9 females. Results: AOFAS score rose from 39.9 in pre-op to 81.4 at 12 months, with a considerable reduction of pain (score from 13.1 to 31.5, max 40), and improvement of ankle alignment (from 5.4 to 9.1, max 10) and function (from 21.4 to 40.8, max 50). Spatiotemporal parameters obtained with gait analysis showed a good recovery at 6 months and a successive settlement on the operated site: i.e. mean stride length normalised (81.9, % of height, for control group) was 63.0 pre-op, 70.5 at 6 months and 71.0 at 12 months; speed (127.8 cm/s for control group) rose from 79.2 to 100.8 cm/s at 6 months and 102.7 cm/s at 12 months. Ankle joint rotation range improved in all three anatomical planes at 6 months, somehow maintained at 12 months; in particular in the sagittal, there was an increase of max dorsi-flexion in the stance phase (2.58 pre-op, 5.48 and 6.28 at 6 and 12 months), though a persistent limited plantar-flexion at initial contact and a moderate reduction of plantar-flexion during swing were observed at. Plantar-flexion moment showed a smoother pattern after surgery (Fig. 1). Discussion: The novel ankle prosthesis seems to contribute to an early functional recovery at 6 months maintained at one year. Preliminary assessments at 24 months confirmed the improvements achieved at 12 months. With reduction of pain and recovery of joint control, the gait variables of high clinical interest, such as stance balance and ability in propulsion, improve.

Clinics in Shoulder and Elbow, 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the... more We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complicat...