Pin and plate fixation in complex distal humerus fractures: surgical technique and results

Abstract

Purpose Complex distal humerus fractures are difficult to fix by conventional methods, especially in comminuted low distal humerus fractures. We propose a technique using small diameter K-wires and a plate on the humeral shaft. Methods Between May 2007 and March 2009, 19 patients with poor bone quality showing comminuted or low distal humerus fractures involving the articular surface were referred to our institution and were primarily treated by this technique that we called "pin and plate fixation". We have reviewed all the cases treated by this method. Results The average age was 46 years. All of the patients were followed up for a mean of 12 months and had a good range of motion (the average total arc of flexion-extension was 99°); the average Disabilities of the Arm, Shoulder and Hand (DASH) score was 18 points. The Mayo Elbow Performance Index was measured and the mean score was 88 in our patients. Conclusions In this study, a technique has been evaluated for the treatment of complex distal humerus fractures. We recommend this technique in comminuted, osteoporotic or low distal humerus fractures in which other fixation methods seem difficult or even impossible.

Triceps Split: A Safe and Useful Approach for Distal Humeral Fractures

“…At least 100 o of both elbow flexion, extension and forearm rotation are required to perform most basic activities of daily living [3,52]. Our results of mean flexion-extension arc and mean fore-arm rotation of the operated arm are within the range of the above stipulated functional ROM, and within the results of other studies [4,21,[33][34][35][36]39,40].…”

“…On the other hand, reoperations were quite frequent (35%) mostly due to implant removal and local ulnar nerve symptoms. Complications and re-operations seem to be within the array of most studies reporting a range of 21% to 50% reoperations and complications for this kind of fracture [1,4,12,20,[34][35][36]39,40]. Olecranon osteotomy is the surgical approach most often used for plating distal humeral fractures, type C, as it is reported to provide better visualization of the articular part of the distal humerus compared with triceps reflecting and triceps splitting approaches [25].…”

Comparison of two different double-plate fixation methods with olecranon osteotomy for intercondylar fractures of the distal humeri of young adults

“…This requires anatomic reconstruction of the articular surface, restitution of the overall geometry of the distal humerus and stable fixation of the fracture fragments to allow early and full rehabilitation. Although these goals are now widely accepted by the orthopedic community (8,11,12,17,18), they may be technically difficult to achieve, particularly in the presence of substantial comminution.…”

US sanctions and its consequences on orthopedic surgery on Iran

“…Previously, Iranian surgeons have announced several novel techniques in the literature in order to replace the Western instruments with domestic instruments or alternative techniques to provide better outcomes in various clinical cases, which have been always challenging for all physicians worldwide, such as humerus fracturs treatment, distal humerus bone graft, radius fractures, femoral fracturs, etc. [8][9][10][11][12][13]. In instance, an Iranian study carried out on patients who suffered complex distal humerus fracture, and authors used K-wires to reconstruct and restabilize the surface of the bone [11,14].…”

“…[8][9][10][11][12][13]. In instance, an Iranian study carried out on patients who suffered complex distal humerus fracture, and authors used K-wires to reconstruct and restabilize the surface of the bone [11,14]. However, considering the application of the sanctions, these products will not be accessible and easy-to-afford for Iranian patients, that might lead to less safety and more complications among patients, and they will be obstructed from receiving the best cure for their diseases.…”