Experience in Treatment of Distal Humeral Epimetaphyseal Intra-Articular Fractures Using Combined Osteosynthesis by Submersible Screws and External Fixation Hinge Distraction System

BACKGROUND: Severe injuries of the elbow joint and their consequences are a serious problem in modern traumatology and orthopedics due to the large number of unsatisfactory treatment results, in particular, due to the lack of a differentiated approach to the choice of tactics and the method of surgery. AIM: To evaluate the results of a differentiated approach to the choice of tactics and the method of surgical intervention in the treatment of patients with injuries and consequences of injuries of the elbow joint. MATERIALS AND METHODS: The results of treatment of 245 patients with injuries and consequences of damage to the elbow joint were assessed within 11 years from the date of surgery. Six groups of patients were identified: group 1 osteosynthesis of fractures of the elbow joint; 2nd open arthrolysis without the imposition of Oganesyans hinged distraction apparatus (HDA); 3rd open arthrolysis with the imposition of HDA; 4th arthroscopic arthrolysis without HDA imposition; 5th arthroscopic arthrolysis with the imposition of HDA; 6th elbow arthroplasty. RESULTS: In 93% of patients after osteosynthesis (1st group of patients), a good result was obtained (the deficit in the range of motion was not more than 10, the average score on the DASH scale was 8). In patients after arthrolysis, there is a twofold increase in the range of motion (on average from 4250 to 114120), and regardless of the method of arthrolysis (arthroscopic or open) and whether HDA was used or not. On the DASH scale, 89% of patients showed a decrease in points on average from 77 to 36. In the 6th group, an increase in the range of motion was noted on average from 4548 to 126135, on the DASH scale a decrease in points from 7982 to 3944 on average. Revision intervention was required in 28.4%. CONCLUSION: The choice of the method of surgical treatment of injuries and the consequences of severe injuries of the elbow joint directly depends on the degree and nature of destruction of the bone-articular and soft tissue structures, the deficit in the range of motion in the joint.

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Reconstructive surgeries and endoprosthetics of the elbow joint: indications, possibilities and prospects

Kesyan

Arsen’ev

Urazgil'deev

et al. 2021

N.N. Priorov Journal of Traumatology and Orthopedics

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Surgical Treatment of Open Comminuted Intra-Articular Transcondylar Fracture of Humerus With Displaced Fracture Fragments (Clinical Case)

Yamshikov

2023

Tambov Medical Journal

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Complex intra-articular fractures require active patient management tactics and almost always the use of surgical treatment. For intra-articular fractures, it is extremely important to restore the normal anatomical structure, precise reposition and fixation of the fracture, without which it is impossible to restore the full function of the joint and limb. Surgical treatment should be carried out as early as possible in order to prevent the development of contractures. The purpose of this publication is to demonstrate the successful experience of treating a patient with an open comminuted intra-articular transcondylar fracture of humerus with displaced fracture fragments and the validity of the choice of an operative method of treatment of this pathology. Materials and methods : description of a clinical case and a brief analysis of the literature on this issue. Presented case of open reposition of a comminuted intra-articular transcondylar fracture of the shoulder and extra-cortical osteosynthesis with two reconstructive plates is successful. The effectiveness of treatment was evaluated based on the data of X-ray examination methods, as well as assessing the function of the limb and the amplitude of movement in the elbow joint. Results : performed open reposition of a comminuted intra-articular transcondylar fracture of shoulder and extra-cortical osteosynthesis with two reconstructive plates. Complete restoration of limb function and anatomical integrity of the distal metaepiphysis of the humerus has been achieved, the patient’s ability to work has been restored.

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Experience in Treatment of Distal Humeral Epimetaphyseal Intra-Articular Fractures Using Combined Osteosynthesis by Submersible Screws and External Fixation Hinge Distraction System

Cited by 2 publications

References 6 publications

Reconstructive surgeries and endoprosthetics of the elbow joint: indications, possibilities and prospects

Reconstructive surgeries and endoprosthetics of the elbow joint: indications, possibilities and prospects

Surgical Treatment of Open Comminuted Intra-Articular Transcondylar Fracture of Humerus With Displaced Fracture Fragments (Clinical Case)

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