Clinical Efficacy of a Micro-locking Plate Vertical or Parallel Technique for Treatment of Dubberley B-type Capitellar Fractures

Abstract

ObjectiveTo evaluate the clinical efficacy of micro-locking plate through vertical or parallel technique for treatment of Dubberley B-type capitellar fractures.MethodsA retrospective analysis was performed in 24 patients (seventeen males and seven females, with an average age of 44.9 years, range from 19 to 75 years) with capitellar fractures that were treated with micro-locking plate using vertical or parallel technique between January 2016 to January 2019. The inclusion criteria include closed capitellar fracture, anterior elbow joint movement normal before injury, recent capitellar fracture with times of injury within past 3 weeks. Fractures classified according to Dubberley included 4 cases of type IB, 8 cases of type IIB and 12 cases of type IIIB. Radiographic evaluation was performed. Surgery time, blood lose, range of motion of the elbow, forearm rotation and complications was recorded. Elbow joint function was evaluated by Mayo Elbow Performance Score (MEPS).ResultsThe mean follow-up period was 19.6 months (range, 12–36 months). The average clinical healing time for fractures was 11.2 ± 3.2 weeks (range, 8–20 weeks). Fracture united in all patients. Two patients showed slight delayed union, but union was achieved eventually. The mean time from injury to surgery was 6.3 ± 3.1 days (range, 2–15 days). The average surgical time was 68.1 ± 11.5 minutes(range, 50–90 minutes), and the mean blood loss was 75.2 ± 26.5 mL༈range, 40–120 mL). The mean range of flexion was 122.5°±10.5°༈range, 95°-140°). The mean range of extension was 8.5°±5.8°༈range, 0°-20°). The mean range of pronation was 79.7°±8.0°༈range, 65°-90°). The mean range of supination was 80.5°±7.1°༈range,60°-90°). The mean MEPS at final follow-up was 89.8 ± 9.0 (range, 60–100). Based on the MEPS, 18 (75%) patients had excellent, 5 (20.8%) patients had good and 1 (4.2%) patient had fair. None of the 24 patients suffered vascular or nerve injury. One patient showed superficial infection, which terated with surgical dressing.Conclusions The micro-locking plate accroding to vertical or parallel technique is an excellent method for Dubberley B-type capitellar fractures.