Best care paradigm to optimize functionality after extra-articular distal humeral fractures in the young patient

Ayoub, Mark; Tarkin, Ivan S.

doi:10.1016/j.jcot.2018.02.002

Cited by 10 publications

(8 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because long-term elbow immobilization leads to stiffness, the conservative management protocols in distal humeral fractures play a role for inoperable geriatrics [6] . The dispute for a triceps-sparing rather than a triceps-splitting [detaching] approach used in young active adults with distal humerus fracture was further reinforced by the expanded elbow range of motion [ROM] as well as preservation of the triceps strength that has been shown in the muscle-sparing technique [7] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Safy¹

2021

International Journal of Medical Arts

View full text Add to dashboard Cite

Background: Distal humerus fractures had acquired an attention due to poor outcomes regardless of treatment modality which may be conservative or surgical. These fractures can be addressed with either triceps splitting or triceps sparing approach. The triceps sparing approach was performed by lateral window was developed on the lateral side of the triceps as it is elevated off the posterior border of the intermuscular septa and posterior humerus. Objective:The current work aimed to evaluate the outcome of surgical treatment of fracture distal humerus through triceps sparing approach.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the current study, ORIF was applied for 33 patients with distal humerus fractures through triceps-sparing approach. The mean elbow flexion was 140.45±3.82 degrees [135-145], and the mean elbow extension was 9.96±2.98 degrees [6][7][8][9][10][11][12][13][14][15]. Radiological outcome was achieved in all patients.…”

Section: Discussionmentioning

confidence: 99%

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Safy¹

2021

International Journal of Medical Arts

View full text Add to dashboard Cite

show abstract

“…The association of metaphyseal comminution also adds further difficulties in non-surgical treatment [7] . Prolonged bracing or casting results in delay in return to work and also stiffness of the elbow joint [8] . The use of conventional plating system in this area is a challenging task due to the smaller distal fragment which engages lesser number of screws and also impingement by the plate upon the olecranon fossa [9] .…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of treatment of extra articular distal humerus fractures using pre contoured distal humerus locking compression plate: A retrospective study

Kumar¹,

Vijay²

2020

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Background: Extra-articular distal humerus fractures are difficult and challenging entities to manage owing to the complex anatomy of distal part of humerus as well as complicated fracture morphology. Functional cast bracing does not provide adequate stabilisation of these fractures apart from having other brace related complications. To overcome this problem, surgical intervention is the preferred method of treating these fractures with its share of complications like infection, non-union, implant failure and iatrogenic radial nerve palsy. Intra-medullary nailing and fixation with conventional plates is not a good option due to inadequate fixation in short distal fragment. The use of pre contoured, extra-articular distal humerus plates have emerged as a standard treatment in managing such fractures. This study was aimed to evaluate the clinical and functional outcome of managing such fractures using extra-articular distal humerus locking plates. Methods: This retrospective study was carried out at Integral Institute of Medical Sciences And Research, Lucknow from September 2013 till August 2016. Out of the 47 patients records analysed, only 25 patients qualified for this study. All the patients were operated using the posterolateral triceps reflecting approach to the humerus. All the fractures were fixed using extra-articular distal humerus locking plates. All the patients were followed for 12-18 months with a mean of 16 months. The clinical and functional outcome was assessed using the Mayo Elbow Performance score (MEPS) for elbow and University of California Los Angeles (UCLA) rating scale for the shoulder function. Results: At the final follow-up according to MEPS we had 18 patients showing excellent results (72%), 6 had Good results (24%) and 1 patient had Fair results (4%). According to UCLA, we had 22 patients (88%) Excellent results, while remaining 3 patients (12%) had Good results at final follow-up. No case of malunion or non-union was reported in our study. 1 patient developed superficial infection which was managed by daily dressing. 2 patients developed post-operative radial nerve palsy which recovered spontaneously. In 1 patient implant removal was warranted due to prominence of the hardware but that too after the fracture had united. Conclusion: Stable fixation of these fracture and early mobilisation of the elbow joint are the key features to have an optimal outcome after the surgery. Using the pre contoured, extra-articular distal humerus locking plate with minimal soft tissue stripping has yielded good results with early return to normal function.

show abstract

“…Prolonged bracing or casting may result in delay in return to work and stiffness of the elbow joint [ 6 ]. Surgical management with conventional plates is mechanically unstable because of inappropriate number of screws in the short distal fragment with additional risk of impingement of the plate on olecranon fossa [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Extra-Articular Distal Humerus Fractures Fixed by Single Column Extra-Articular Distal Humerus Locking Compression Plate Using Triceps Sparing Postero-Lateral Approach

Ali¹,

Mir

Dar

et al. 2018

BEAT

View full text Add to dashboard Cite

Objective:To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.Methods:This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal humeral fractures managed by operative fixation using extra-articular distal humerus locking plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus locking plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score (MEPS). Complications and need for any additional procedures was also recorded.Results:A total of 20 patients with mean age of 36.5 years and an average follow up of 17 months were included. The mean time to radiological union was 17.4 weeks (12 to 36 weeks) which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94.7±8 with 19 patients having excellent and good results. Conclusion: Use of extra-articular distal humeral locking plate using lateral para-tricepetal approach in extra-articular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications.

show abstract

Best care paradigm to optimize functionality after extra-articular distal humeral fractures in the young patient

Cited by 10 publications

References 55 publications

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

Functional outcome of treatment of extra articular distal humerus fractures using pre contoured distal humerus locking compression plate: A retrospective study

Outcome of Extra-Articular Distal Humerus Fractures Fixed by Single Column Extra-Articular Distal Humerus Locking Compression Plate Using Triceps Sparing Postero-Lateral Approach

Contact Info

Product

Resources

About