Effect of trochleocapitellar index on adult patient-reported outcomes after noncomminuted intra-articular distal humeral fractures

Rollo, Giuseppe; Rotini, Roberto; Eygendaal, Denise; Pichierri, Paolo; Bisaccia, Michele; Prkić, Ante; Stasi, Alessandro; Meccariello, Luigi

doi:10.1016/j.jse.2018.02.073

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…It has been shown [15, 16] that a K-wire perforating the interosseous membrane and impinging on the radius can cause synostosis formation. The most commonly proposed mechanism of synostosis formation is calcification of hematoma in the interosseous membrane.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Radioulnar Synostosis after Olecranon Fracture: A Case Report

Oğuzkaya¹,

Cakar²,

Argun³

2019

Case Rep Orthop Res

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Radioulnar synostosis which develops after treatment of isolated olecranon fracture is a rare complication. The aim of this study was to determine the clinical findings and postoperative outcomes of radioulnar synostosis after isolated olecranon fracture in a child patient. A 14year-old girl was evaluated after falling on her left elbow. She had pain, edema, and motion limitation in her left elbow. After radiologic examinations, diagnosis of olecranon fracture was made. Olecranon fracture was fixated by open reduction and internal fixation with tension band wiring method via the posterior approach. When the patient came to the control to remove the implants 9 months after the first operation, there was a limitation in the supination and pronation movements. In the radiographs, synostosis was observed in the proximal region between the radius and ulna. The patient was reoperated to remove the implants. In the same session, synostosis was excised by using the posterior approach, and a barrier between the bones was constituted with bone wax and early elbow range of motion exercises started. In the postoperative first month, the patient had full flexion and extension but with 30 degrees of supination deficit. Radioulnar synostosis is rare but can be seen after isolated olecranon fractures. Early elbow motion after radioulnar synostosis surgery helps the patient to increase joint movement.

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Section: Discussionmentioning

confidence: 99%

“…In intraarticular elbow fractures, anatomic reduction and stable fixation are crucial to obtaining a good outcome. Rollo et al [15] described trochleocapitellar index to measure the postoperative reduction quality and predict the outcome.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Radioulnar Synostosis after Olecranon Fracture: A Case Report

Oğuzkaya¹,

Cakar²,

Argun³

2019

Case Rep Orthop Res

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“…This parameter has an optimal value, as too much varus or valgus within the elbow joint does lead to worsened outcomes. 5 …”

Section: Aterials and M Ethodsmentioning

confidence: 99%

“… 3 Anatomical restoration of length, alignment, rotation and the distal humeral cartilage maintains the optimal stabilising effects of the elbow and forearm muscles and therefore leads to better function and higher patient-reported outcomes. 3 , 5 Complex fractures, poor bone quality, soft tissue lesions and patients’ comorbidities, particularly if associated with incorrect or inadequate internal fixation, favour complications. Open reduction and internal fixation (ORIF) with plates and screws is the treatment of choice in active patients.…”

Section: Introductionmentioning

confidence: 99%

Open Reduction and Internal Fixation Using Double Plating with Biological and Artificial Bone Grafting of Aseptic Non-unions of the Distal Humerus: Clinical Results

Eygendaal¹,

Rollo²,

Vicenti³

et al. 2022

Strategies in Trauma and Limb Reconstruction

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A bstract Aim Intra-articular non-union of fractures is an uncommon but complex problem because in general, it is characterised by marked instability, pain, strength loss and significant functional limitation. The aim of this study is to report our prospective medium-term outcomes of the treatment of intra-articular, distal humeral aseptic non-unions using open reduction and internal fixation, augmented with artificial bone. Materials and methods A retrospective case series of 16 patients with intra-articular, aseptic non-unions of the distal humerus was analysed for range of motion, pain, Mayo Elbow Performance Scores (MEPS) and Oxford Elbow Scores (OES) after 12 months. Mean age was 44 years (range, 18–84 years) and mean total follow-up was 43 months (range, 24–62 months). Results All subjective and objective scores were significantly higher 12 months after treatment with internal fixation and artificial bone augmentation; the mean improvement on the MEPS was 18 points and 17 points on the OES. All patients returned to work, most without limitations. Autografts had worse outcomes compared to allografts regarding post-operative pain and time to return to work. No adverse events related to the artificial bone augmentation were seen and all fractures consolidated. Conclusion The use of two locking plates and bone graft augmentation with autografts or allografts with artificial bone grafts is a successful treatment of intra-articular distal humeral non-unions after hardware failure or biological limitations. Clinical significance The use of artificial bone in the treatment of septic non-unions of the upper limb is safe. When no autograft is possible because of concurrent morbidity, it can be used alone or combined with an allograft to reconstruct the affected bone without leading to extra morbidity or complications. How to cite this article Rollo G, Vicenti G, Rotini R, et al. Open Reduction and Internal Fixation Using Double Plating with Biological and Artificial Bone Grafting of Aseptic Non-unions of the Distal Humerus: Clinical Results. Strategies Trauma Limb Reconstr 2021;16(3):144–151.

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“…Surgical options include open reduction internal fixation (ORIF), hinged or non-hinged external fixation, and elbow replacement. The advent of anatomic preshaped locked plates and elbow arthroplasty have changed the management of distal humerus fractures [ 1 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Temporary spanning plate across the elbow for complex fractures of the distal humerus

Moharram

Mahmoud

Lymona

et al. 2021

BMC Musculoskelet Disord

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Background Open reduction internal fixation (ORIF) is the gold standard management of fractures of the distal humerus. Stable fixation to allow early mobilization is not always possible in cases with comminuted fracture patterns and bone loss, with a high failure rate. We propose augmentation of internal fixation in these unstable situations with a spanning plate across the elbow to protect the fixation construct temporarily until bone union. Methods Eighteen patients with complex distal humeral fractures were managed with standard ORIF technique augmented with a temporary plate spanning across the elbow as an internal fixator. Cases included were either very distal, comminuted (6 cases) or insufficiency fractures (4 cases) or revision fixation cases (8 cases). The temporary spanning plate was removed as soon as signs of early radiographic union were detected. Results Seventeen patients were available for final follow up at a mean 28.3 months. The spanning plate was removed after 3.4 months on average. At the final follow-up, the mean elbow total arc of motion was 86.3°. The mean Mayo Elbow Performance Score (MEPS) was 80, and the mean Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score was 27. Conclusion Spanning the elbow temporarily with a plate in adjunct to standard ORIF technique is both simple and effective in achieving fracture stability and union and minimizes failure rates after fixation of comminuted, very distal fractures, osteoporotic cases, or revision fixation cases with bone loss. Level of evidence Level IV, Therapeutic study

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Effect of trochleocapitellar index on adult patient-reported outcomes after noncomminuted intra-articular distal humeral fractures

Cited by 13 publications

References 19 publications

Pediatric Radioulnar Synostosis after Olecranon Fracture: A Case Report

Pediatric Radioulnar Synostosis after Olecranon Fracture: A Case Report

Open Reduction and Internal Fixation Using Double Plating with Biological and Artificial Bone Grafting of Aseptic Non-unions of the Distal Humerus: Clinical Results

Temporary spanning plate across the elbow for complex fractures of the distal humerus

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