Is Ulnar Nerve Transposition Beneficial During Open Reduction Internal Fixation of Distal Humerus Fractures?

2010 ◽  
Vol 24 (7) ◽  
pp. 391-394 ◽  
Author(s):  
Ryan C Chen ◽  
David J Harris ◽  
Stephane Leduc ◽  
Joseph J Borrelli ◽  
Paul Tornetta ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Ulnar Nerve ◽  
Open Reduction ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Ulnar Nerve Transposition ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Nerve Transposition

scholarly journals The role of ulnar nerve subcutaneous anterior transposition during open reduction and internal fixation of distal humerus fractures: a retrospective cohort study

2020 ◽  
Vol 44 (12) ◽  
pp. 2701-2708 ◽  
Author(s):  
Abdulaziz F. Ahmed ◽  
Ashik Mohsin Parambathkandi ◽  
Wai Jing Geraldine Kong ◽  
Motasem Salameh ◽  
Aiman Mudawi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Internal Fixation ◽  
Ulnar Nerve ◽  
Retrospective Cohort Study ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Distal Humerus ◽  
Anterior Transposition ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Abstract Purpose To compare the rates of ulnar nerve neuropathy following ulnar nerve subcutaneous anterior transposition versus no transposition during open reduction and internal fixation (ORIF) of distal humerus fractures. Methods This was a retrospective cohort study at an academic level I trauma centre. A total of 97 consecutive patients with distal humerus fractures underwent ORIF between 2011 and 2018. All included patients were treated with plates (isolated lateral plates excluded) and had no pre-operative ulnar neuropathy. Subcutaneous ulnar nerve anterior transposition was compared versus no transposition at the time of ORIF. The main outcome measure was the rate of ulnar nerve neuropathy. The secondary outcomes were the severity of the ulnar nerve neuropathy and the rate of ulnar nerve recovery. Results Twenty-eight patients underwent subcutaneous ulnar nerve anterior transposition during ORIF, whereas 69 patients had no transposition. Transposition was associated with significantly higher rates of ulnar nerve neuropathy (10/28 versus 10/69; P = 0.027). An adjusted logistic regression model demonstrated an odds ratio of 4.8 (1.3, 17.5; 95% CI) when transposition was performed. Ulnar nerve neuropathy was classified as McGowan grades 1 and 2 in all neuropathy cases in both groups (P = 0.66). Three out of ten cases recovered in the transposition group, and five out of ten cases recovered in the no transposition group over a mean follow-up of 11.2 months (P = 1.00). Conclusion We do not recommend performing routine subcutaneous ulnar nerve anterior transposition during ORIF of distal humerus fracture as it was associated with a significant 5-fold increase in ulnar nerve neuropathy.

scholarly journals Open reduction internal fixation with triceps-sparing approach in distal humerus fracture: an experience from a tertiary level hospital in Mangalore

2019 ◽  
Vol 5 (2) ◽  
pp. 345
Author(s):  
Bhaskar Bhandary ◽  
Sachin Shetty ◽  
Mohammed Shabir Kassim ◽  
Amlan Mohapatra
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Open Reduction ◽  
Final Analysis ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Range Of Movement ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

<p class="abstract"><strong>Background:</strong> Fractures of the distal humerus represent challenging problems to an orthopaedic surgeon. The present study aimed to assess the range of movement after performing open reduction and internal fixation of distal humerus fractures treated with triceps sparing approach.</p><p class="abstract"><strong>Methods:</strong> This prospective study included all skeletally mature patients with distal humerus fractures and operated at our center with open reduction and internal fixation of distal humerus with triceps on or triceps sparing approach were included in the study. During the study period 30 cases underwent surgery and were included in the final analysis. Fractures were classified according to the AO/OTA classification. Patients will be followed up at 6 weeks, 12 weeks and at 6 months. Mean range of motion of the fractured elbow at different follow up points were compared.<strong></strong></p><p class="abstract"><strong>Results: </strong>The mean age of the total population was 37.7±13.8 years, 57% males and left side was affected in 60% of the patients. Majority of the patients had a range of motion in normal elbow in the range 0 to 140 degrees. There was an increase in the mean range of movement from 63.4±14.2 at 6<sup>th</sup> week to 120±6 at 24<sup>th</sup> week, and this change was statistically significant (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Future multicentric randomized studies, specially comparing triceps-sparing with olecranon osteotomy, are needed to support the results of our study.</p>

scholarly journals Number of screws in the articular segment of distal humerus AO/OTA C-type fractures treated with open reduction internal fixation is associated with complication rate

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
Brian F. Grogan ◽  
Nicholas C. Danford ◽  
Cesar D. Lopez ◽  
Stephen P. Maier ◽  
Pinkawas Kongmalai ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Complication Rate ◽  
Open Reduction ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Introduction: Surgical treatment of distal humerus fractures can lead to numerous complications. Data suggest that the number of screws in the distal (articular) segment may be associated with complication rate. The purpose of this study is to evaluate the association between a number of screws in the distal segment and complication rate for surgical treatment of distal humerus fractures. We hypothesize that the number of screws in the articular segment of distal humerus AO/OTA C-type fractures treated with open reduction internal fixation (ORIF) will be inversely proportional to the complication rate. Methods: We performed a single-center retrospective cohort study of 27 patients who underwent ORIF of distal humerus fractures C-type with at least six months of radiographic and clinical follow-up. Clinical outcomes including a range of motion, pain, revision surgery for stiffness and/or heterotopic ossification (HO), nonunion, and persistent ulnar nerve symptoms requiring revision neurolysis were recorded. Results: In C-type fractures, the use of three or fewer articular screws was significantly associated with nonunion or loss of fixation (RR 17, p = 0.006). Nineteen of 36 (53%) patients experienced at least one complication. The surgical approach, plate configuration, age, and ulnar nerve treatment (none, in situ release, transposition) were not associated with the need for revision surgery. Men had a higher risk of requiring surgical contracture release due to improving post-operative stiffness (RR 12, p = 0.02). Conclusion: In this retrospective study, the use of three or fewer screws to fix articular fragments in AO type C fractures was a significant risk for nonunion or loss of fixation. Plate configuration and surgical approach did not correlate with outcomes. Men had higher rates of complications and required more frequent revision surgery compared to women.

Open Reduction and Internal Fixation of Distal Humerus Fractures

2006 ◽  
Vol 7 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Matthew L. Ramsey ◽  
Andrea K. Bratic ◽  
Charles L. Getz ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Open Reduction and Internal Fixation of Distal Humerus Fractures

2010 ◽  
Vol 20 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Danny P. Goel ◽  
Jeffrey M. Pike ◽  
George S. Athwal
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Humerus Fractures ◽  
Distal Humerus Fractures
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