Orthogonal versus Parallel Plating for Distal Humeral Fractures

Moon, Jun Gyu; Lee, Ji Ho

doi:10.5397/cise.2015.18.2.105

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…Several biomechanical studies reported parallel plating is more rigid than orthogonal plating. But clinical studies that prove parallel plating is superior than orthogonal plating is still not enough[ 19 , 20 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Complications associated with open reduction and internal fixation for adult distal humerus fractures: a multicenter retrospective study

Han

Park²,

Baek

et al. 2022

J Orthop Surg Res

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Background Open reduction and plate fixation are the preferred treatment options for most distal humerus fractures in adults. However, it is often challenging for orthopedic surgeons because of the complex anatomy and the difficulty in achieving stable fixation. This multicenter study aimed to analyze the complication types and rates of patients with distal humerus fractures treated with open reduction and plate fixation, and compare the results with those found in the literature. In addition, we describe the clinical outcomes. Methods This retrospective multicenter study was conducted between September 2001 and March 2021 and included data from four hospitals. In total, 349 elbows underwent surgical treatment at these hospitals during the study period. Patients > 17 years of age who were treated by plate fixation were included, and patients who were treated by other fixation methods were excluded. A total of 170 patients were included in the study. The following types of complications were investigated: (1) nerve related; (2) fixation and instrument related; (3) osteosynthesis related; (4) infection; and (5) others. Results The following complications were found: (1) 26 (15.3%) cases of postoperative ulnar nerve symptoms; 4 (2.4%) of postoperative radial nerve symptoms; (2) one (0.6%) case of screw joint penetration and screw loosening; and eight (4.7%) cases of hardware removal due to instrument skin irritation; (3) seven (4.1%) cases of nonunion; (4) two (1.2%) and four (2.2%) cases of superficial and deep infection, respectively, and seven (3.9%) cases of wound complication; and (5) 37 (21.8%) cases of heterotrophic ossification, 79 (46.5%) cases of elbow stiffness (did not achieve functional range of motion [ROM]), and 41 (24.1%) cases of osteoarthritis over Broberg and Morrey Grade I. Paradoxically, the postoperative ulnar nerve symptoms were more frequent in the prophylactic ulnar nerve anterior transposition group. However, this difference was not statistically significant (p = 0.086). The mean ROM was 123.5° flexion to 9.5° extension. The average Disabilities of the Arm, Shoulder and Hand (DASH) score was 14.5 ± 15.6. Conclusions Open reduction and plate fixation for distal humeral fractures is a reasonable treatment option with acceptable complication rates and favorable clinical outcomes. Surgeons must be vigilant about ulnar nerve complications. Level of Evidence Therapeutic Level III.

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Section: Discussionmentioning

confidence: 99%

Complications associated with open reduction and internal fixation for adult distal humerus fractures: a multicenter retrospective study

Han

Park²,

Baek

et al. 2022

J Orthop Surg Res

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“…There is no consensus that whether the orthogonal or parallel plating is superior for fixation. [31][32][33] We used orthogonal plating because it provides better mechanical stability although it requires more extensive soft tissue dissection. The functional outcome was based upon the Mayo Elbow Performance Score which was excellent in 24 patients (60%), good in 8 patients (20%), fair in 6 patients (10%), and poor in 2 patients (5%).…”

Section: Discussionmentioning

confidence: 99%

Management of intercondylar fractures of the distal humerus in adults using bi-columnar plating through trans-olecranon approach

Yadav¹,

Ganie

Prasad

et al. 2021

Int J Res Orthop

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Background: Inter-condylar fractures of the distal humerus are uncommon injuries and present the most difficult challenge among fractures of the lower end of the humerus. The principle involves anatomical reduction and fixation with stabilization of extra-osseous implants. The functional outcome has been greatly influenced by the early graduated rehabilitative exercise. We aimed to evaluate the functional outcome of inter-condylar fractures of the distal humerus in adults using bi-columnar plating through a trans-olecranon approach.Methods: A prospective study with 40 adult patients with inter-condylar fracture of the distal humerus were managed with bi-columnar plating through a trans-olecranon approach and were followed up for 12 months. The functional outcome was analysed by Mayo’s Elbow Performance Score (MEPS) at the end of 12 months follow up.Results: The average age of study participants were 50.8 years. A total of 24 cases were due to RTA and 16 cases were due to direct falls. Out of 40 cases, 6 (15%) were of B1 type, 2 (5%) were of type B2, 12 (30%) were of C1, 10 (25%) of C2, and 10 (25%) were of the type of C3 according to AO classification. According to MEPS at the end of the 12th-month follow-up, excellent results were seen in 24 (60%), good in 8 (20%), fair in 6 (15%), and poor results in 2 (5%) cases.Conclusions: Anatomically, bi-columnar plating for distal humerus is useful in providing stable fixation for complex distal articular fractured by trans-olecranon approach and facilitating early postoperative rehabilitation. Clinical and radiological results showed a good healing rate with a good range of motion.

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WITHDRAWN: Functional outcomes of type C distal humerus fractures in adults fixed by orthogonal double plating

et al. 2017

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Orthogonal versus Parallel Plating for Distal Humeral Fractures

Cited by 6 publications

References 33 publications

Complications associated with open reduction and internal fixation for adult distal humerus fractures: a multicenter retrospective study

Complications associated with open reduction and internal fixation for adult distal humerus fractures: a multicenter retrospective study

Management of intercondylar fractures of the distal humerus in adults using bi-columnar plating through trans-olecranon approach

WITHDRAWN: Functional outcomes of type C distal humerus fractures in adults fixed by orthogonal double plating

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