Distal Humerus Intra-articular Fractures: Fixation Using Dual Plating

2019 ◽  
pp. 25-32
Author(s):  
Nirmal C. Tejwani ◽  
Ruchi Tejwani
Keyword(s):  
Distal Humerus ◽  
Articular Fractures ◽  
Dual Plating

scholarly journals Study of clinical outcome in intra articular distal humerus fractures treated with dual plating

2017 ◽  
Vol 5 (6) ◽  
pp. 2438
Author(s):  
Riyaz B. Shaik ◽  
Venugopala Reddy P. ◽  
Ashok Naidu K.
Keyword(s):  
Clinical Outcome ◽  
Road Traffic ◽  
Distal Humerus ◽  
Complex Nature ◽  
Lateral Column ◽  
Dual Plating ◽  
Surgical Fixation ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Fracture Humerus

Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating.Methods: This is a prospective type of study of 20 cases of supra condylar fracture humerus with inter condylar extension treated surgically with dual plating one on the medial boarder and another on posterior surface of lateral column using standard dorsal approach, olecranon osteotomy.Results: The range of age was between 18-52 years, with mean age of 32.55 years. The maximum incidence was between 18 to 40 years i.e. 16 cases (80%). With road traffic accident (RTA) as major cause of injury. Most   of the patients were males 14 (70%) with right upper limb was involved in 12 (60%) cases. According   to MEP score clinical outcome was excellent in 4(20%) good in 10(50%) fair in 5(25%) and poor in one (10%).Conclusions: Distal humerus fractures are known for their complex nature and technical difficult in surgical management. Proper anatomical articular reconstruction and stable fixation helps in restoring painless and functional elbow.

scholarly journals THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS

2010 ◽  
Vol 16 (3) ◽  
pp. 96-102
Author(s):  
V. V. Klyuchevsky ◽  
Hassan Ben El Hafi
Keyword(s):  
Soft Tissues ◽  
Functional Results ◽  
Distal Humerus ◽  
Distal Segment ◽  
Rigid Fixation ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Articular Fractures ◽  
Active Mobilization ◽  
Violent Acts

From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.

Clinical Application and Outcomes of Upper Extremity Double Plating

2019 ◽  
Vol 158 (02) ◽  
pp. 227-237 ◽  
Author(s):  
J. Christoph Katthagen ◽  
Benedikt Schliemann ◽  
Philipp A. Michel ◽  
Lukas F. Heilmann ◽  
Felix Dyrna ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Mechanical Stability ◽  
Distal Humerus ◽  
Fixation Strength ◽  
Anterior Plate ◽  
Proximal Ulna ◽  
Lesser Tuberosity ◽  
Dual Plating ◽  
Fixation Techniques ◽  
Complex Proximal Humeral Fractures

AbstractDual plating in fractures of the upper extremity is well established for the distal humerus. The indication for the use of dual plating has been expanded over the last few years. While dual plating was originally frequently used in revisions of non-unions, it is nowadays also used in primary fixation of diverse complex fractures of the upper extremity. The high biomechanical fixation strength of dual plating is advantageous in regions with high bending and torsional stresses, such as the humeral shaft. An additional anterior plate provides high fixation strength and reduces the risk of loss of reduction in complex proximal humeral fractures and allows for direct fixation of lesser tuberosity fragments. Low-profile plates have been introduced for complex proximal ulna fractures. In dual plating the improved mechanical stability is combined with a reduced risk of implant related soft tissue irritations. The present article provides an overview of current indications for dual plating of upper extremity fractures and outlines technical aspects as well as advantages over conventional fixation techniques.

scholarly journals Coronal shear fractures of the distal humerus: Current concepts and surgical techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Jay J Watson ◽  
Simon Bellringer ◽  
Joideep Phadnis
Keyword(s):  
Clinical Experience ◽  
Surgical Techniques ◽  
Distal Humerus ◽  
Humeral Fractures ◽  
Articular Fractures ◽  
Distal Humeral Fractures

Coronal shear fractures of the distal humerus are a unique subset of distal humeral fractures which entail partial or complete articular fractures of the distal humerus without involvement of the columns. The very distal nature of these fragments, their small size and propensity for comminution render them challenging to treat surgically. The purpose of this article is to describe the classification, outcomes and surgical techniques currently used for the treatment of these fractures using the available literature and authors' clinical experience.

Operative treatment of type C intra-articular fractures of the distal humerus: the role of stability achieved at surgery on final outcome

Injury ◽  
1995 ◽  
Vol 26 (3) ◽  
pp. 169-173 ◽  
Author(s):  
N. Papaioannou ◽  
G.Ch. Babis ◽  
J. Kalavritinos ◽  
Th. Pantazopoulos
Keyword(s):  
Operative Treatment ◽  
Distal Humerus ◽  
Final Outcome ◽  
Articular Fractures ◽  
Type C

scholarly journals Functional and radiological outcomes of distal humerus fractures treated with pre-contoured locking compression plate

2022 ◽  
Author(s):  
Pravin K. Vanchi ◽  
Raghav R. V. ◽  
Mohan Kumar M.
Keyword(s):  
Range Of Motion ◽  
Distal Humerus ◽  
Locking Compression Plate ◽  
Osteoporotic Bone ◽  
Articular Fractures ◽  
Compression Plate ◽  
Maximum Range ◽  
Angle Stable ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

<p><strong>Background: </strong>Distal humerus intra-articular fractures are one of the complicated fractures managed by orthopaedic surgeons. We did a prospective and a retrospective study on 21 patients with these fractures treated with pre-contoured locking compression plate.</p><p><strong>Methods: </strong>The<strong> </strong>21 patients in this series were followed for a minimum of 1 year. The prospective study cases were followed at 3 months, 6 months and annually. The rating system of the Mayo elbow functional scoring system was used. The radiological evaluation was done using standard AP and lateral views.<strong></strong></p><p><strong>Results: </strong>We had 14 patients with range of motion of 50-100 degrees. There was only one patient with range of motion of &lt;50 degrees. 6 patients had the maximum range motion of &gt;100 degrees. We had 6 (23.57%) excellent, 9 (42.85%) good, 5 (23.80%) fair and 1 (4.7%) poor in the Mayo elbow scoring at the end of 1 year. We were able to compare our outcomes with a study done by Kumar et al done in 2017. They had 27 (89.66%) of excellent and good results as opposed to 27 (79.4%) in our study. Out of 21 patients in our study 17(80.95%) patients had good 11 (52.5%) / excellent 6 (28.5%) results. This was comparable with Jupiter et al. His study of 34 patients 26 (79.40/0) patients showed good 14 (41%) / excellent 13 (38.4%) result.<strong></strong></p><p><strong>Conclusions: </strong>Pre-contoured locking compression plate appears to be technically an ideal implant for comminuted osteoporotic bone providing an angle stable construct.</p>

scholarly journals Functional outcome of locking anatomical plate in extra articular fractures of the distal humerus

2019 ◽  
Vol 5 (3) ◽  
pp. 443
Author(s):  
Amit Chandrakant Supe ◽  
Nikhil Dilip Palange ◽  
Eknath D. Pawar ◽  
Neetin P. Mahajan
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Distal Humerus ◽  
Radial Nerve Palsy ◽  
Dash Score ◽  
Articular Fractures ◽  
Early Return ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

<p class="abstract"><strong>Background:</strong> Extra articular distal humerus fractures are difficult to treat with conventional implants like intra medullary nail, 4.5 DCP and dual plate. The present study aims to study the functional outcome of the extra articular distal humerus plate (EADHP).</p><p class="abstract"><strong>Methods:</strong> 48 patients with displaced extra articular distal humerus fractures were included in the study. Inclusion criteria were age more than 18 years, closed fractures with or without radial nerve palsy and less than 3 weeks old trauma. Patients aged less than 18 years, those having open fractures, fractures more than 3 weeks old, non – unions and pathological fractures were excluded from the study. All patients were operated with EADHP. Clinically, the outcome was assessed by the disability of arm, shoulder and hand (DASH) score and elbow range of motion radiologically, union was evaluated on anteroposterior and lateral radiographs.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 48 patients, 12 had AO type 12 A1 fracture, 26 patients had type B1 fractures and remaining 10 had type C1 fractures. Mean DASH score at final follow up was 18.1; range being 12.6 to 35.7 points. The mean elbow range of motion was 0 to 130 degrees (range: 120 to 140 degrees). The mean duration for complete radiological fracture union was 14 weeks, range being 12 to 18 weeks.</p><p class="abstract"><strong>Conclusions:</strong> The extraarticular distal humerus plate is an ideal implant for the fixation of distal humerus fractures since it provides good stability of fracture and enables early return to function.</p>

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