Fixation of Distal Humerus Fractures: Principles and Biomechanics

Satisfactory outcome of intraarticular distal humerus fractures depends on anatomic joint restoration and stable fracture fixation to allow early motion. Orthogonal constructs (medial plate on medial column and posterior plate on lateral column) and parallel constructs (medial plate on medial column and lateral plate on lateral column) have been proposed for fixation of these fractures. However, the optimal configuration remains controversial. There are no clinical studies comparing these constructs and existing biomechanical studies had methodological limitations and reported conflicting results.

Download Full-text

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172425 ◽

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.

Download Full-text

Distal Humerus Fractures, Including Isolated Distal Lateral Column and Capitellar Fractures

Operative Techniques: Shoulder and Elbow Surgery ◽

10.1016/b978-1-4160-3278-6.50067-0 ◽

2011 ◽

pp. 923-958

Author(s):

Jeffry T. Watson

Keyword(s):

Distal Humerus ◽

Lateral Column ◽

Humerus Fractures ◽

Distal Humerus Fractures

Download Full-text

Distal Humerus Fractures, Including Isolated Distal Lateral Column and Capitellar Fractures

Operative Techniques: Shoulder and Elbow Surgery ◽

10.1016/b978-0-323-50880-3.00060-3 ◽

2019 ◽

pp. 603-627

Author(s):

Jeffry T. Watson

Keyword(s):

Distal Humerus ◽

Lateral Column ◽

Humerus Fractures ◽

Distal Humerus Fractures

Download Full-text

Outcome of Surgical Fixation of Lateral Column Distal Humerus Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000496 ◽

2016 ◽

Vol 30 (5) ◽

pp. 245-250 ◽

Cited By ~ 4

Author(s):

Arvind Von Keudell ◽

Amir R. Kachooei ◽

Ali Moradi ◽

Jesse B. Jupiter

Keyword(s):

Distal Humerus ◽

Lateral Column ◽

Surgical Fixation ◽

Humerus Fractures ◽

Distal Humerus Fractures

Download Full-text

Open or Closed Pinning for Distal Humerus Fractures in Children?

Swiss Surgery ◽

10.1024/1023-9332.9.2.76 ◽

2003 ◽

Vol 9 (2) ◽

pp. 76-81 ◽

Cited By ~ 12

Author(s):

de Buys Roessingh ◽

Reinberg

Keyword(s):

Distal Humerus ◽

Neurological Involvement ◽

Cubitus Varus ◽

Cubitus Valgus ◽

Fractures In Children ◽

Motor Deficiency ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

With Screws ◽

Length Of Hospitalization

Introduction: In children, the choice between percutaneous pinning (PP) and open pinning fixation (OPF) for the surgical treatment of fractures of the distal humerus remains controversial, especially the PP method for internal humeral condylar (IHC) fractures. Patients and methods: Eighty fractures of the distal humerus in children were treated surgically in our hospital over a ten year period. 47% (n = 38) were supracondylar (SC), 20% (n = 16) comminuted (COM), 18% (n = 14) internal humeral condylar (IHC), and 15% (n = 12) lateral humeral condylar (LHC). We used PP, OPF and three times osteosynthesis with screws. Results: In comparison to OPF, PP reduced the length of hospitalization in SC fractures (2.8 versus 6.1 days) and IHC fractures (2.4 versus five days). It reduced the risk of extension deficiency (11.1% versus 15%) and of cubitus valgus (0% versus 20%) in SC fractures, and of cubitus varus in IHC fractures (0% versus 11.1%). However it induced a higher rate of cubitus valgus (11.1% versus 20%) in IHC fractures, one persistent neurological motor deficiency (radial nerve) and four cases of transitional neurological involvement (ulnar nerve). Conclusions: PP is a good surgical method for SC and for also for IHC fractures, if performed by experienced surgeons so as to avoid neurological damage.

Download Full-text