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

Abstract

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.

Development and biomechanical analysis of an axially controlled compression spinal rod for lumbar spondylolysis

“…Our innovative approach, ACCSR, adheres to the AO fracture healing standard. [13] ACCSR offers several advantages: ACCSR, aided by intraoperative C-arm fluoroscopy and direct visual observation, allows controllable compression facilitating anatomical reduction of the gap during surgery; By enabling continuous compression, ACCSR ensures tight closure of the fracture ends, securing initial stability and promoting bone graft fusion in later stages; ACCSR requires exposure of only the spondylolysis, the lower lamina edge, and the superior facet joint of the isthmic vertebral body, eliminating the need to expose the transverse process and the inferior facet joint; and Post-surgery, patients can wear a brace to get out of bed on the first day after surgery, and engage in early mobilization, a strategy that aligns with similar successful approaches reported in other studies, such as Allende et al [29] use of double tension band fixation for distal humeral fractures. The mechanism involves the use of tension band compression to bring together the fractured ends, thereby achieving controllable compression on the fracture sites to prevent elbow joint deformities, and demonstrates that controlled compression facilitates the anatomical reduction of fracture ends with significant clinical efficacy.…”

Клінічні Результати Лікування Переломів Ліктьового Відростка За Методикою Інтрамедулярного Блокованого Металоостеосинтезу

“…проаналізували результати лікування 239 пацієнтів із переломами ліктьового відростка або після остеотомії ліктьового відростка, яким було виконано фіксацію за Weber. Кількість незадовільних результатів лікування залишається високою і становить 18,5-45,6 %, за даними різних авторів [4][5][6]. Було виявлено 10 основних помилок при виконанні металоостео-синтезу за Weber, які в подальшому призводять до ускладнень і негативних результатів лікування [4].…”