Three-dimensional mapping of distal humerus fracture

Abstract

Background Distal humerus fractures (DHFs) constitute one-third of elbow fractures approximately. In this study, we aim to define and analyze the fracture lines and morphological features of DHFs using mapping technique. Methods One hundred and two DHFs were retrospectively reviewed. All the computed tomography (CT) data were used to manually reconstruct and virtually reduce the DHF fragments to fit a standard 3D model. Smooth curves were depicted accurately onto the surface of the template to represent the fracture lines. All the curves were overlapped onto the model to create the 3D fracture map and heat map. Results Our analysis was based on 102 CT images of DHFs, contributed by 59 male and 43 female patients (mean age, 46 years; range, 18-93 years), and included 15 type A, 25 type B, and 62 type C fractures. On mapping, the hot zones were located in the radial fossa, coronoid fossa, olecranon fossa, and the external part of the trochlear. Conversely, the cold zones were noted in medial condyle, the medial side of the trochlear, and the anterolateral area on the supracondylar ridge. Conclusions Our study firstly shows the fracture lines and morphological features of distal humeral fractures by three-dimensional mapping technology. Distal humerus fracture lines are characteristic and highly related to the micro-architecture difference of distal humerus, which may provide some guidance for the treatment plan selection and surgical fixation design.

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

“…These four patients were treated using lateral plate longer than 100% of trans-epicondylar distance(TED). It is consistent with result of Wang at el[ 1 ].…”

“…Distal humerus fracture in adults is one of the most challenging injuries to treat for orthopedic surgeons. Complex regional anatomy containing neurovascular, articular comminution, and a limited point for secure fixation makes it challenging for surgeons to achieve anatomical reduction and stable fixation [ 1 ]. Some orthopedic surgeons are not familiar with distal humeral fractures because of their relatively low incidence in adults [ 2 ].…”

Statistical Morphology and Fragment Mapping of Complex Proximal Humeral Fractures

“…The interest in fracture mapping has recently been increasing with applications for various anatomical locations [ 16 , 18 , 19 , 20 , 21 , 22 , 23 ]. The previously presented methods have demonstrated an increasing trend in terms of accuracy.…”

“…As an example, Dugarte et al showed that a 3D analysis of scapular fracture morphology was more accurate than the 2D method [ 17 ]. This technique has been adapted and applied to several anatomical locations [ 16 , 18 , 19 , 20 , 21 , 22 , 23 ]. Most studies defined a single fracture line transcribed from the position between two fragments.…”

Conversion from Spanning External Fixation to Open Reduction Internal Fixation Contributes to Healing of Soft Tissues and Fractures in Open Distal Humeral Fractures

“…Distal humeral fractures (DHFs) comprise approximately 2% of all adult fractures and one-third of all humeral fractures [ 1 ]. The complex anatomy of elbow articulation, including the distal humerus, proximal ulna, and radial head, leads to complex intra-articular fractures in the distal humerus.…”