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Published in: International Orthopaedics 3/2011

01-03-2011 | Original Paper

Bilateral plate fixation for type C distal humerus fractures: experience at a single institution

Authors: Shao-hua Li, Zhen-hua Li, Zheng-dong Cai, Yu-chang Zhu, Yong-zhen Shi, Jie Liou, Kun Tao, Jian-guang Wang

Published in: International Orthopaedics | Issue 3/2011

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Abstract

Type C fractures of the distal humerus are difficult to treat and typically require open anatomical reduction and internal fixation. Here we describe our experience treating patients with type C distal humerus fractures using a trans-olecranon approach with bilateral plate fixation. Fifty-six patients (30 males, 26 females; mean age 49.8 years) were treated over a period of six years. Thirteen fractures were open and 43 closed; all were caused by falls or traffic accidents. All operations were performed successfully with no intraoperative complications. Mean duration of follow-up was 30 months (range 6–70). Mean duration of fracture healing was 2.8 months (range 2–4). Forty-seven out of 56 patients (84%) suffered no postoperative complications. One patient exhibited symptoms of ulnar nerve injury following surgery (nine exhibited symptoms before and after surgery). Two patients had mild cubitus varus deformities, four delayed olecranon osteotomy site healing, and two heterotopic ossifications. In summary, complications were minimal and outcomes satisfactory in patients with type C distal humerus fractures who underwent bilateral plate fixation via a trans-olecranon approach.
Literature
1.
go back to reference O’Driscoll SW (2005) Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg 14:186S–194SPubMedCrossRef O’Driscoll SW (2005) Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg 14:186S–194SPubMedCrossRef
2.
go back to reference Luo Y, Liu W (2005) Treatment of comminuted intra-articular fractures of the distal humerus with double tension band and cancellous screw. Chin J Orthop Trauma 9:885–887 Luo Y, Liu W (2005) Treatment of comminuted intra-articular fractures of the distal humerus with double tension band and cancellous screw. Chin J Orthop Trauma 9:885–887
3.
go back to reference Ali AM, Hassanin EY, El-Ganainy AE, Abd-Elmola T (2008) Management of intercondylar fractures of the humerus using the extensor mechanism-sparing paratricipital posterior approach. Acta Orthop Belg 74:747–752PubMed Ali AM, Hassanin EY, El-Ganainy AE, Abd-Elmola T (2008) Management of intercondylar fractures of the humerus using the extensor mechanism-sparing paratricipital posterior approach. Acta Orthop Belg 74:747–752PubMed
4.
go back to reference Shrader MW (2008) Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am 39:163–71 Shrader MW (2008) Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am 39:163–71
6.
go back to reference Hoellen IP, Bauer G, Holbein O (1997) Prosthetic humeral head replacement in dislocated humerus multi-fragment fracture in the elderly—an alternative to minimal osteosynthesis? Zentralbl Chir 122:994–1001PubMed Hoellen IP, Bauer G, Holbein O (1997) Prosthetic humeral head replacement in dislocated humerus multi-fragment fracture in the elderly—an alternative to minimal osteosynthesis? Zentralbl Chir 122:994–1001PubMed
7.
go back to reference Pajarinen J, Bjorkenheim JM (2002) Operative treatment of type C intercondylar fractures of the distal humerus: results after a mean follow-up of 2 years in a series of 18 patients. J Shoulder Elbow Surg 11:48–52PubMedCrossRef Pajarinen J, Bjorkenheim JM (2002) Operative treatment of type C intercondylar fractures of the distal humerus: results after a mean follow-up of 2 years in a series of 18 patients. J Shoulder Elbow Surg 11:48–52PubMedCrossRef
8.
go back to reference Kinzl L, Fleischmann W (1991) The treatment of distal upper arm fractures. Unfallchirurg 94:455–460PubMed Kinzl L, Fleischmann W (1991) The treatment of distal upper arm fractures. Unfallchirurg 94:455–460PubMed
10.
go back to reference Boykin RE, Baskies MA, Harrod CC, Jupiter JB (2009) Intraoperative distraction in the upper extremity. Tech Hand Up Extrem Surg 13:75–81PubMedCrossRef Boykin RE, Baskies MA, Harrod CC, Jupiter JB (2009) Intraoperative distraction in the upper extremity. Tech Hand Up Extrem Surg 13:75–81PubMedCrossRef
11.
go back to reference Gilbert SR, Conklin MJ (2007) Presentation of distal humerus physeal separation. Pediatr Emerg Care 23:816–819PubMedCrossRef Gilbert SR, Conklin MJ (2007) Presentation of distal humerus physeal separation. Pediatr Emerg Care 23:816–819PubMedCrossRef
12.
go back to reference Pollock JW, Athwal GS, Steinmann SP (2008) Surgical exposures for distal humerus fractures: a review. Clin Anat 21:757–768PubMedCrossRef Pollock JW, Athwal GS, Steinmann SP (2008) Surgical exposures for distal humerus fractures: a review. Clin Anat 21:757–768PubMedCrossRef
13.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation J Bone Joint Surg Am 51:737–755 Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation J Bone Joint Surg Am 51:737–755
14.
go back to reference Dabezies EJ, D’Ambrosia R (1986) Fracture treatment for the multiply injured patient. Instr Course Lect 35:13–21PubMed Dabezies EJ, D’Ambrosia R (1986) Fracture treatment for the multiply injured patient. Instr Course Lect 35:13–21PubMed
15.
go back to reference Blum J, Gercek E, Hansen M, Rommens PM (2005) Operative strategies in the treatment of upper limb fractures in polytraumatized patients. Unfallchirurg 108:843–849PubMedCrossRef Blum J, Gercek E, Hansen M, Rommens PM (2005) Operative strategies in the treatment of upper limb fractures in polytraumatized patients. Unfallchirurg 108:843–849PubMedCrossRef
16.
go back to reference Xu S, Huang C, Zhang M (2001) Surgical treatment of humeral condylar fractures. Chin J Bone Joint Surg 16:208 Xu S, Huang C, Zhang M (2001) Surgical treatment of humeral condylar fractures. Chin J Bone Joint Surg 16:208
17.
go back to reference Yang KH, Park HW, Park SJ, Jung SH (2003) Lateral J-plate fixation in comminuted intercondylar fracture of the humerus. Arch Orthop Trauma Surg 123:234–238PubMed Yang KH, Park HW, Park SJ, Jung SH (2003) Lateral J-plate fixation in comminuted intercondylar fracture of the humerus. Arch Orthop Trauma Surg 123:234–238PubMed
18.
go back to reference Wei W, Zhang T, Xin J (2005) The treatment and its results of type C fractures of distal humerus. Chin J Orthop 25:679–681 Wei W, Zhang T, Xin J (2005) The treatment and its results of type C fractures of distal humerus. Chin J Orthop 25:679–681
19.
go back to reference McCarty LP, Ring D, Jupiter JB (2005) Management of distal humerus fractures. Am J Orthop 34:430–438PubMed McCarty LP, Ring D, Jupiter JB (2005) Management of distal humerus fractures. Am J Orthop 34:430–438PubMed
20.
go back to reference Prokopis PM, Weiland AJ (2008) The triceps-preserving approach for semiconstrained total elbow arthroplasty. J Shoulder Elbow Surg 17:454–458PubMedCrossRef Prokopis PM, Weiland AJ (2008) The triceps-preserving approach for semiconstrained total elbow arthroplasty. J Shoulder Elbow Surg 17:454–458PubMedCrossRef
21.
go back to reference Hausman M, Panozzo A (2004) Treatment of distal humerus fractures in the elderly. Clin Orthop Relat Res 425:55–63 Hausman M, Panozzo A (2004) Treatment of distal humerus fractures in the elderly. Clin Orthop Relat Res 425:55–63
22.
go back to reference Brauer CA, Lee BM, Bae DS, Waters PM, Kocher MS (2007) A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. J Pediatr Orthop 27:181–186PubMed Brauer CA, Lee BM, Bae DS, Waters PM, Kocher MS (2007) A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. J Pediatr Orthop 27:181–186PubMed
23.
go back to reference Athwal GS, Rispoli DM, Steinmann SP (2006) The anconeus flap transolecranon approach to the distal humerus. J Orthop Trauma 20:282–285PubMedCrossRef Athwal GS, Rispoli DM, Steinmann SP (2006) The anconeus flap transolecranon approach to the distal humerus. J Orthop Trauma 20:282–285PubMedCrossRef
24.
go back to reference Huang TL, Chiu FY, Chuang TY, Chen TH (2005) The results of open reduction and internal fixation in elderly patients with severe fractures of the distal humerus: a critical analysis of the results. J Trauma 58:62–69PubMedCrossRef Huang TL, Chiu FY, Chuang TY, Chen TH (2005) The results of open reduction and internal fixation in elderly patients with severe fractures of the distal humerus: a critical analysis of the results. J Trauma 58:62–69PubMedCrossRef
25.
go back to reference Liu JJ, Ruan HJ, Wang JG, Fan CY, Zeng BF (2009) Double-column fixation for type C fractures of the distal humerus in the elderly. J Shoulder Elbow Surg 18:646–651PubMedCrossRef Liu JJ, Ruan HJ, Wang JG, Fan CY, Zeng BF (2009) Double-column fixation for type C fractures of the distal humerus in the elderly. J Shoulder Elbow Surg 18:646–651PubMedCrossRef
26.
go back to reference Kundel K, Braun W, Wieberneit J, Ruter A (1996) Intraarticular distal humerus fractures. Factors affecting functional outcome. Clin Orthop Relat Res 332:200–208 Kundel K, Braun W, Wieberneit J, Ruter A (1996) Intraarticular distal humerus fractures. Factors affecting functional outcome. Clin Orthop Relat Res 332:200–208
27.
go back to reference Gofton WT, MacDermid JC, Patterson SD, Faber KJ, King GJ (2003) Functional outcome of AO type C distal humeral fractures. J Hand Surg Am 28:294–308PubMedCrossRef Gofton WT, MacDermid JC, Patterson SD, Faber KJ, King GJ (2003) Functional outcome of AO type C distal humeral fractures. J Hand Surg Am 28:294–308PubMedCrossRef
28.
go back to reference LaPorte DM, Murphy MS, Moore JR (2008) Distal humerus nonunion after failed internal fixation: reconstruction with total elbow arthroplasty. Am J Orthop 37:531–534PubMed LaPorte DM, Murphy MS, Moore JR (2008) Distal humerus nonunion after failed internal fixation: reconstruction with total elbow arthroplasty. Am J Orthop 37:531–534PubMed
29.
go back to reference Cil A, Veillette CJ, Sanchez-Sotelo J, Morrey BF (2008) Linked elbow replacement: a salvage procedure for distal humeral nonunion. J Bone Joint Surg Am 90:1939–1950PubMedCrossRef Cil A, Veillette CJ, Sanchez-Sotelo J, Morrey BF (2008) Linked elbow replacement: a salvage procedure for distal humeral nonunion. J Bone Joint Surg Am 90:1939–1950PubMedCrossRef
30.
go back to reference Prasad N, Dent C (2008) Outcome of total elbow replacement for distal humeral fractures in the elderly: a comparison of primary surgery and surgery after failed internal fixation or conservative treatment. J Bone Joint Surg Br 90:343–348PubMedCrossRef Prasad N, Dent C (2008) Outcome of total elbow replacement for distal humeral fractures in the elderly: a comparison of primary surgery and surgery after failed internal fixation or conservative treatment. J Bone Joint Surg Br 90:343–348PubMedCrossRef
Metadata
Title
Bilateral plate fixation for type C distal humerus fractures: experience at a single institution
Authors
Shao-hua Li
Zhen-hua Li
Zheng-dong Cai
Yu-chang Zhu
Yong-zhen Shi
Jie Liou
Kun Tao
Jian-guang Wang
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 3/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1011-y

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