Use of 2 Column Screws to Treat Transcondylar Distal Humeral Fractures in Geriatric Patients

Abstract

We describe fixation of transcondylar distal humeral fractures with column screws in geriatric patients and review our initial results. We conducted a retrospective review of a prospectively collected database at a Level I trauma center. Six patients met inclusion criteria of age older than 65 years and treatment of minimally or nondisplaced transcondylar distal humeral fracture with column screws only. All were closed fractures with no associated nerve injuries. One patient was lost to follow-up. The mechanism of injury was low-energy fall for the 5 remaining patients (average age, 74 y; age range, 70 to 83 y; average follow-up duration, 10.6 wk). One patient had a traumatic brain injury and a contralateral metacarpal fracture that was treated with internal fixation. The remaining 4 patients sustained isolated distal humeral fractures. No complications were noted, and all fractures healed at an average radiographic union time of 7.2 weeks. Average range of motion was 22 degrees extension [95% CI (-1.47, 45.47)], 114 degrees flexion [95% CI (89.4, 138.6)], and 92 degrees arc of motion [95% CI (58.68, 125.38)]. Treatment of select transcondylar distal humeral fractures with column screws in geriatric patients provides an option for stable fixation that allows early range of motion with minimal surgical morbidity.

Outcome of percutaneous kirschner wire fixation for supracondylar fractures of humerus in elderly comorbid patients

“…Similar results were obtained by Vala P et al [13] in their study. Our complication rates were also comparable with other studies in literature [12,14] .…”

Low Transcondylar Fractures of the Distal Humerus: A Multicenter Cohort Study

“…Satisfactory fixation with 2 cannulated screws, applied in a crisscross manner in older patients with transcondylar fractures, has also been reported. 6,7 In our study, union was achieved in 2 patients in group A who were treated with crisscross fixation. This technique must be carefully used in older patients with minimally displaced or undisplaced low transcondylar fractures with longer immobilization.…”

Results of plate fixation for transcondylar fracture of the distal humerus: a rare pattern of fractures

“…A crisscross screw fixation method was introduced for transcondylar distal humeral fractures. 9 , 10 They reported that this method was good to save operation time, and they achieved bony union in all cases. However, the union time was on average 7.2 weeks to 3 months and there was screw loosening in some patients, whereas the mean union time was 5.3 weeks in this study.…”

“…It is reported that most transcondylar humeral fractures occur in older patients after low-energy injuries. 10 , 12 , 18 Therefore, healing of geriatric fractures can be ensured not only by a stable construct of the surgery but also by biologic factors. 18 The transcondylar area is thought to be prone to fractures because the bones in that region of the body are relatively thin.…”