Internal fixation for coronal shear fracture of the distal end of the humerus by the anterolateral approach

Imatani, Junya; Morito, Yoshiaki; Hashizume, Hidetoshi; Inoue, Hajime

doi:10.1067/mse.2001.118005

Cited by 57 publications

(37 citation statements)

References 4 publications

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“…Furthermore, the clinical and functional results in the Type-IV fracture subgroup in our series are consistent with the results reported in other series dedicated to this complex coronal plane fracture 3,7,8,16 . In this group, the average arc of ulnohumeral motion was 109°and the mean MEPI score was 91 points, corresponding with a good to excellent result in seven of the eight patients.…”

Section: Discussionsupporting

confidence: 92%

“…The mean flexion contracture of 18°in the Type-IV fracture subgroup in the present study is in accordance with previously reported results 3,16 . While we counsel patients who have Type-IV fracture patterns in advance about the possibility of development of a flexion contracture, our results and those of the aforementioned studies 3,8,16 suggest that a functional ulnohumeral arc is achievable in the majority of patients. All Type-IV fractures in the present series were sustained during low-energy falls, and several authors 2,3,6,8 have confirmed this finding.…”

Section: Discussionmentioning

confidence: 56%

“…Studies evaluating the outcomes following open reduction and internal fixation of capitellar fractures 2,3,6,8,9,[15][16][17][18] and associated injuries of the trochlea, radial head, and lateral collateral ligamentous complex are limited. The purpose of the present study was to evaluate clinical, radiographic, and patient-based functional outcomes following the open reduction and internal fixation of capitellar fractures with use of a uniform surgical approach and fixation construct in order to further define the impact of fracture type and concomitant osseous and/or ligamentous injuries involving the lateral column on the outcome.…”

mentioning

confidence: 99%

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Open Reduction and Internal Fixation of Capitellar Fractures with Headless Screws

Ruchelsman

Tejwani

Kwon

et al. 2008

The Journal of Bone & Joint Surgery

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Despite the presence of greater flexion contractures at the time of follow-up in elbows with Type-IV fractures or fractures with an ipsilateral radial head fracture, good to excellent outcomes with functional ulnohumeral motion can be achieved following internal fixation of these complex fractures. Type-IV injuries may be more common than previously thought; such fractures often are associated with metaphyseal comminution or a radial head fracture and may require supplemental fixation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 99%

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Open Reduction and Internal Fixation of Capitellar Fractures with Headless Screws

Ruchelsman

Tejwani

Kwon

et al. 2008

The Journal of Bone & Joint Surgery

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“…[6] Ring recommended olecranon osteotomy for cases with medial extension, particularly when medial epicondyle is involved. [2] The “built-on” technique can be performed through the extensile lateral approach.…”

Section: Discussionmentioning

confidence: 99%

Distal humerus shear-fractures: "Built-on" surgical technique

Rapariz

Martin

Far-Riera

et al. 2014

Int J Shoulder Surg

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When treating a distal humeral shear fracture, comminution of the lateral column may preclude the reconstruction of the lateral articular fragments.In this article a new strategy for the management lateral column comminuted shear-fractures (LCCSF) is presented, called the “built-on” surgical technique. Three goals are obtained by this technique: (1) Restoration of the lateral column bone stock; (2) Provision of a solid scaffold for the repair of the lateral ulnar collateral ligament (LUCL); and (3) Provision of a sable platform for the reconstruction and fixation of the articular fragments.We will obtain these goals through the following surgical steps:1/ Reconstruction of the lateral trochlea.2/ Reconstruction of the lateral column3/ Fixation of the Capitellum4/ Reconstruction of the LUCL

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“…This approach has advantage that it approaches the capitellum and trochlea without disruption of LCL or an olecranon osteotomy [17,18] . The incision begins proximally overlying the lateral aspect of the biceps muscle.…”

Section: Anterolateral Approachmentioning

confidence: 99%

Coronal shear fractures of distal humerus: Diagnostic and treatment protocols

Singh¹,

Singh²

2015

WJO

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Coronal shear fractures of distal humerus involving the capitellum and the trochlea are rare injuries with articular complexity, and are technically challenging for management. With better understanding of the anatomy and imaging advancements, the complex nature of these fractures is well appreciated now. These fractures involve metaphysealcomminution of lateral column and associated intraarticular injuries are common. Previously, closed reduction and excision were the accepted treatment but now preference is for open reduction and internal fixation with an aim to provide stable and congruent joint with early range of motion of joint. Various approaches including extensile lateral, anterolateral and posterior approaches have been described depending on the fracture pattern and complexity. Good to excellent outcome have been reported with internal fixations and poor results are noted in articular comminution with associated articular injuries. Various implants including headleass compression screws, minifragment screws, bioabsorbable implants and column plating are advocated for reconstruction of these complex fractures. Inspite of articular fragments being free of soft tissue attachments the rate of osteonecrosis and osteoarthritis is reported very less after internal fixation. This article summarizes the diagnostic and treatment strategies for these rare fractures and recommendations for management.

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Internal fixation for coronal shear fracture of the distal end of the humerus by the anterolateral approach

Cited by 57 publications

References 4 publications

Open Reduction and Internal Fixation of Capitellar Fractures with Headless Screws

Open Reduction and Internal Fixation of Capitellar Fractures with Headless Screws

Distal humerus shear-fractures: "Built-on" surgical technique

Coronal shear fractures of distal humerus: Diagnostic and treatment protocols

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