Outcome after internal fixation of intraarticular distal humerus (AO type B &amp; C) fractures: Preliminary results with anatomical distal humerus LCP system

Patel, J.; Motwani, Girish; Shah, Himanshu; Daveshwar, Rajeev

doi:10.1016/j.jcot.2017.02.004

Cited by 27 publications

(17 citation statements)

References 19 publications

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“…Although intraarticular distal humerus fractures are rare, they present a clinical challenge for orthopaedic surgeons due to the complex anatomy of the distal humerus and difficulty in exposing the fracture. The main surgical goal of fixation of such fractures is to achieve a stable joint with a good range of pain free movement [1][2][3][4][5] . Many fixation methods have been proposed; the use of K-wires, screw fixations, Y-shaped plates, single plates and double plates.…”

Section: Discussionmentioning

confidence: 99%

“…Among them the dual plating osteosynthesis through a posterior approach with an olecranon osteotomy is now considered an acceptable treatment modality [1][2][3][6][7][8][9] , It offers excellent posterior visualization of the distal humerus, without any untoward effect on triceps strength and postoperative rehabilitation [6][7][8][9][10][11][12][13][14] . Recently many national and international studies have focused attention on the importance of surgical approach and stable fixation for early elbow mobilization [1][2][3][4][5][6][7][8][9][10][11][12][13][14]18,19 . In this study we had used a posterior approach with an olecranon osteotomy in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Inter-condylar distal humerus fractures (DHF) in adult is one of the most problematic fracture that requires not only accurate reduction of the articular surface and restoration of fracture anatomy of the distal humerus but also require a rigid fixation of the fracture fragments to enable early postoperative mobilization [1][2][3][4][5] A number of techniques have been used to treat such inter-condylar DHF in adult; all of them, fixation with dual plating through posterior approach with an olecranon osteotomy is now considered an accepted treatment modality [1][2][3][6][7][8][9] . Recently several authors have pointed out the importance of surgical approach, rigid fixation and early elbow mobilization for good [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . This method of fixation provides rigid fixation; while use of posterior approach with olecranon osteotomy minimize the risk of triceps injury thus allowing early post-operative rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

2017

J Liaquat Uni Med Health Sci

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INTRODUCTION: The dual plate osteosynthesis technique for fixation of inter-condylar distal humerus fracture is now considered an accepted treatment modality. It provides a rigid fixation of fracture fragments to enable early post-operative mobilization for good outcome. OBJECTIVE: The purpose of study is to assess the morbidity and clinico-radiological outcome of the dual plating osteosynthesis technique used for fixation of inter-condylar distal humerus fractures (DHF) via trans-olecranon approach METHODOLOGY: This perspective cross sectional study was carried at Department of Orthopaedic Surgery, Dow Medical College / Civil Hospital Karachi from June 2014 to March 2016. A total of 21adult patients with comminuted inter-condylar fracture of the distal humerus operated with dual plating osteosynthesis technique via trans-olecranon approach were evaluated clinically and radiologically for functional outcome based on Jupiter criteria including alignment and fracture union after a mean follow-up of 8 months. Post surgical complications were noted. Fractures were classified according to Muller et al (AO). Patients with polytrauma, pathological fracture, open fracture and a fracture more than 2 week old were excluded from the study. RESULTS: Out of the 21 patients, 38% were female and 62% were male. 52.3% had left elbow while 47.6% had right elbow involvement. The mean age was 31 years (range 20-50 years). Mean time between injury and internal fixation was 4.8 days. The mean follow-up period was 8 months. As per AO classification, 10 cases were C1, 7 cases C2 while 4 cases were in C3. The most common cause of fracture was road traffic accident in 13 cases. All fractures achieved anatomical restoration of articular surface and were united in average 14.6 weeks. The clinical results were evaluated for functional outcome based on Jupiter criteria. According to that criterion, satisfactory results were obtained in all patients. We had no instance of postoperative deep infection and neurological complications, only Backing of olecranon K-wires were noted in 5 patients (23.8%). CONCLUSIONS: We conclude that dual plate osteosynthesis technique is an effective procedure for fixation of inter-condylar distal humerus fracture, achieves rigid fixation and hence, early mobilization. Additionally use of olecranon osteotomy offers best fracture exposure of distal humerus. Complications were minimal and healing satisfactory.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

2017

J Liaquat Uni Med Health Sci

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“…In surgical treatment of distal humerus fractures, locking plates are frequently used [1][2][3]. An advantage of locking plates is angle stability between the plate and screws [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Development of three-dimensional preoperative planning system for the osteosynthesis of distal humerus fractures

et al. 2020

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Background: To reproduce anatomical reduction and appropriate implant placement/choices during osteosynthesis for elbow fractures, we developed a 3D preoperative planning system. To assess the utility of 3D digital preoperative planning for the osteosynthesis of distal humerus fractures, we evaluated the reproducibility of implant reduction shapes and placements in patients with distal humerus fractures. Methods: Twelve patients with distal humerus fractures who underwent osteosynthesis using 3D preoperative planning were evaluated. Reduction shapes were evaluated by the angle between the diaphysis axis and a line connecting the vertices of the medial epicondyle and the lateral epicondyle (epicondyle angle), and the angle between the diaphysis axis and the articular surface (joint angle) in the coronal plane, and the distance between the anterior diaphysis and the anterior articular surface in the sagittal plane (anterior distance) based on 3D images of the distal humerus. In addition, the implant positions were evaluated by the positions of the proximal and posterior edge of the plate, and the angle of the plate to the epicondyle line. The reproducibility was evaluated by intra-class correlation coefficients of the parameters between pre-and postoperative images. Results: The intra-class correlation coefficients were 0.545, 0.802, and 0.372 for the epicondyle angle, joint angle, and anterior distance, respectively. The differences in the measurements between the preoperative plan and postoperative reduction were 2.1 ± 2.1 degrees, 2.3 ± 1.8 degrees, and 2.8 ± 2.0 mm, for the epicondyle angle, joint angle, and anterior distance, respectively. The intra-class correlation coefficients were 0.983, 0.661, and 0.653 for the proximal and posterior plate positions, and the angle to the epicondyle, respectively. The differences in the measurements between the preoperative plan and postoperative reduction were 3.3 ± 2.1 mm, 2.7 ± 1.7 mm and 9.7 ± 9.8 degrees, for the plate positions of proximal and posterior edge, and the angle of the plate to the epicondyle line, respectively. There were significant correlations for the epicondyle angle, joint angle, and plate positions. Conclusions: 3D preoperative planning for osteosynthesis of distal humerus fracture was reproducible for the reduction shape of the coronal view and the plate positions.

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“…In recent reports, implant removal varies between 0-28% with the plates on the proximal ulna being the most frequently removed (Theivendran et al 2010, Huang et al 2011, Flinkkila et al 2014, Patel et al 2017). …”

Section: Implant Removalmentioning

confidence: 99%

Arthroplasty in Elbow Fracture Treatment

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Outcome after internal fixation of intraarticular distal humerus (AO type B & C) fractures: Preliminary results with anatomical distal humerus LCP system

Cited by 27 publications

References 19 publications

Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

Development of three-dimensional preoperative planning system for the osteosynthesis of distal humerus fractures

Arthroplasty in Elbow Fracture Treatment

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