Double tension band osteosynthesis in supra- and transcondylar humeral fractures

Houben, P.; Bongers, K J; Wildenberg, F.A.J.M.v.d.

doi:10.1016/0020-1383(94)90241-0

Cited by 24 publications

(9 citation statements)

References 9 publications

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“…Only two patients had heterotopic ossifications Brooker types I and II [7] Discussion Fractures involving the distal humerus are difficult to manage because of the complex anatomy. Many techniques have been described in the fixation of distal humerus fractures, such as double TBW [8], Y-plating [9], orthogonal plating, parallel position of the plates [10] and the DHP system [5].…”

Section: Complicationsmentioning

confidence: 99%

Pin and plate fixation in complex distal humerus fractures: surgical technique and results

Kamrani

Mehrpour

Aghamirsalim

et al. 2011

International Orthopaedics (SICOT)

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Purpose Complex distal humerus fractures are difficult to fix by conventional methods, especially in comminuted low distal humerus fractures. We propose a technique using small diameter K-wires and a plate on the humeral shaft. Methods Between May 2007 and March 2009, 19 patients with poor bone quality showing comminuted or low distal humerus fractures involving the articular surface were referred to our institution and were primarily treated by this technique that we called "pin and plate fixation". We have reviewed all the cases treated by this method. Results The average age was 46 years. All of the patients were followed up for a mean of 12 months and had a good range of motion (the average total arc of flexion-extension was 99°); the average Disabilities of the Arm, Shoulder and Hand (DASH) score was 18 points. The Mayo Elbow Performance Index was measured and the mean score was 88 in our patients. Conclusions In this study, a technique has been evaluated for the treatment of complex distal humerus fractures. We recommend this technique in comminuted, osteoporotic or low distal humerus fractures in which other fixation methods seem difficult or even impossible.

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Section: Complicationsmentioning

confidence: 99%

Pin and plate fixation in complex distal humerus fractures: surgical technique and results

Kamrani

Mehrpour

Aghamirsalim

et al. 2011

International Orthopaedics (SICOT)

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“…There is less agreement, however, with regard to treatment of extra-articular fractures of the distal humerus, with some authors suggesting conservative treatment and others a surgical one [21][22][23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

The use of parallel pre-contoured plates in the treatment of A and C fractures of the distal humerus

2009

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The purpose of this study was to retrospectively evaluate the clinical and radiological results of fixation with parallel pre-contoured plates in intra-articular and extra-articular distal humerus fractures. We retrospectively evaluate seven cases of type A and six cases of type C fracture treated with the Mayo Clinic Congruent Elbow Plate system (Acumed, Hillsboro, Oregon) after a mean follow-up of 14.8 and 21.3 months, respectively. Mayo Elbow Performance Score (MEPS) was utilized for functional evaluation. Mean MEPS was (92.86 +/- 16.8) in the first group showing 6 excellent and one poor result, while (94.17 +/- 12) showing five excellent and one fair in the second group, showing no significant difference between the two groups (P = 0.87). The mean active motion recovered postoperatively was 120 degrees (+/-34.5 degrees) in type A fractures and 113 degrees (+/-14.7 degrees) in type C fractures, and there was no significant difference (P = 0.67). Complications occurred in 6 of the 13 patients analysed at follow-up (3 radial neuropathy, one ulnar neuropathy, one screw mobilization and one heterotopic ossification). The fractures healed in every patient, and no synthesis failed. The parallel plate system has proved to be extremely useful in the treatment of intra-articular and extra-articular distal humerus fractures. The pre-contoured geometry allows easier reduction and stabilization of complex fractures. The higher stability achieved permits early mobilization, thus obtaining a higher percentage of excellent results.

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“…Although the use of percutaneous K-wires is the fixation method of choice for supracondylar distal humerus fractures in children, the use of K-wires alone in distal humerus fractures in adults has given bad results and is not recommended [2,4]. On the other hand, there is evidence supporting the use of tension band wiring in supracondylar distal humerus fractures with good functional results; Houben et al [6] reported comparable results in ten patients with type C distal humerus fractures, five treated with double tension band osteosynthesis and five with double plate, for fixation of the condylar block to the shaft of the humerus. Zhao et al [5] reported 24 patients with comminuted intra-articular fractures treated with double band osteosynthesis achieving 83 % excellent or good results.…”

Section: Discussionmentioning

confidence: 99%

“…The latest reviews in treatment of distal humerus fractures emphasize the fact that dual plate fixation, with placement of a separate strong plate on each column, is indicated for all adult fractures involving both columns of the distal part of the humerus [3,4]; one author even states that failure to adhere to the principles of rigid fixation with a strong plate on each column can dramatically increase nonunion rates [3]. But, there are previous reports in the literature of comparable results achieved using double tension band osteosynthesis or combining tension bands with other fixation methods in supra and intercondylar humeral fractures instead of double plating for fixation of the condylar block to the shaft [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Double tension band osteosynthesis in transverse supracondylar distal humerus fractures and nonunions

Allende

Gutiérrez

Savoy

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the objective and subjective results achieved after double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions in adults. Methods Nine patients presenting six fractures and three nonunions of the distal humerus, treated with double tension band wiring between 1998 and 2011, were retrospectively evaluated. Two fractures were type A2 and four type A3, and the nonunions were oligotrophic; all nine lesions had a supracondylar intracapsular transverse orientation, that passed through the olecranon fossa, in a direction parallel to the joint line, and they compromised both columns of the distal humerus. Patient's age averaged 70 years (range, 56-82). Results Follow-up averaged 24.6 months (range, 12-53). All fractures and nonunions united; there were no infections, elbow stiffness or heterotopic bone formations. DASH score at final follow-up averaged 14.2 points (range, 4-22). The analog scale of pain averaged 1.1 points (range, 0-3). Elbow range of motion averaged 100°(range, 100-120°). Flexion averaged 123°(range, 115-130°) and elbow extension loss averaged 15.5°(range, 10-25°).Conclusions The results achieved with double tension band fixation in transverse extra-articular intracapsular supracondylar distal humerus fractures and nonunions are comparable to the results that can be expected when using other available fixation methods; this technique is faster, less demanding and cheaper, and surgeons should have it in mind when leading with these particular types of distal humerus fractures and nonunions.

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Double tension band osteosynthesis in supra- and transcondylar humeral fractures

Cited by 24 publications

References 9 publications

Pin and plate fixation in complex distal humerus fractures: surgical technique and results

Pin and plate fixation in complex distal humerus fractures: surgical technique and results

The use of parallel pre-contoured plates in the treatment of A and C fractures of the distal humerus

Double tension band osteosynthesis in transverse supracondylar distal humerus fractures and nonunions

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