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>

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 Transverse olecranon osteotomy with Gigli saw: A fast and reliable technique

2021 ◽  
Vol 6 (1) ◽  
pp. 17-21
Author(s):  
Bulent Karslioglu
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Distal Humerus ◽  
Chevron Osteotomy ◽  
Elbow Fractures ◽  
Significant Difference ◽  
Transverse Osteotomy ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

Objective. Distal humerus fractures constitute of approximately 2% of all fractures and 30% of elbow fractures. Olecranon osteotomy provides excellent exposure of distal humerus and articular surface. In this study, we aimed to compare transverse osteotomy with gigli saw and classical chevron osteotomy techniques in terms of osteotomy duration and clinical results. Materials and Methods. 40 elbows of 40 patients with Type B intraarticular distal humerus fractures according to AO classification were included in our study. Patients were divided into 2 groups as transverse or chevron osteotomy groups. Patients were evaluated in terms of intraoperative osteotomy time, postoperative time to union, range of motion in the elbow joint and Quick Dash scores at 6th, 12th and 24th months. Results. The mean age of the patients was 45.6 years (19-62). 40% of the patients (8 patients) in the Chevron group had more than 2 mm stepping at articular surface, while this rate was 10% (2 patients) in the gigli saw group. Union was obtained in all patients for both techniques. There was no significant difference between the mean QuickDASH scores and range of motion of the elbow joints except flexion in both groups. Range of motion of flexion was statistically better in the gigli saw group (p<0.05). Conclusions. Transverse osteotomy technique significantly reduces osteotomy and fixation time and will not cause problems in fracture union. It may be preferred because it is simpler and faster to apply than chevron osteotomy and because intra-articular stepping is less common.

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>

ORIF with orthogonal plating in the management of complex distal humerus fractures -A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6060-6065
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Distal Humerus ◽  
Dash Score ◽  
Functional Evaluation ◽  
Elderly Age ◽  
Excellent Outcome ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

Fractures of the distal humerus are quite challenging due to the nature of the fracture. They are compounded by factors such as gross and osteoporosis, especially in the elderly age group. This study was performed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures with orthogonal plating. Thirty patients with complex fractures of the distal humerus who presented between April 2011 to April 2014 were managed with ORIF with orthogonal plating. They were followed up for three years. Functional evaluation was performed using the MEPS (Mayo elbow performance score) and the DASH score (Disabilities of arm, shoulder and hand). The right elbow was more commonly affected, as seen in 16 patients, and the most common mode of injury was road traffic accidents. The average time to fracture union was 11.6 weeks. The mean MEPS score was 88.5±11.6 with 85.6% of patients having a good or excellent outcome, and the mean DASH score was 23.2 points. ORIF with orthogonal plating of complex distal humerus fractures provides a stable fixation construct and gives good functional outcomes to the patient.

scholarly journals Evaluation of functional outcome after osteosynthesis of intra articular distal humerus fracture with pre contoured locking compression plates

2020 ◽  
Vol 6 (6) ◽  
pp. 1215
Author(s):  
Faisal S. Mohammed ◽  
Akshay B. Ingale
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Distal Humerus Fracture ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Locking Compression Plates ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Extensor Lag

<p><strong>Background:</strong> Intra articular distal humerus fractures are challenging and cumbersome to treat. Therefore osteosynthesis of such fractures is required. The aim of our study was to evaluate the functional outcome of intra articular distal humerus fractures AO type  13C by osteosynthesis using olecranon osteotomy with pre contoured locking compression plates in orthogonal plate configuration.</p><p><strong>Methods:</strong> Thirty patients were included in our study comprising of 18 males and 12 females. Mean age was 39.63 years with mean follow up of 34 weeks. 7 were AO type 13C1, 9 were AO type 13C2 and 14 were AO type 13C3. Osteosynthesis was done for all fractures by olecranon osteotomy approach. Functional outcome was assessed using mayo elbow performance score.</p><p><strong>Results:</strong> Mean flexion attained at the end of follow up was 127.56 degrees with mean extensor lag of 7.16 degrees. Mean arc of motion was 120.4 degrees. Mean mayo elbow performance score at the end of follow up was 80.36. Mayo elbow performance score in patients aged less than 40 years of age was not statistically significant as compared to patients more than 40 years of age. Functional outcome was also dependent on fracture subtype.</p><p><strong>Conclusions:</strong> Osteosynthesis of distal humerus fractures AO type 13C using pre contoured locking compression plates in orthogonal plate configuration by olecranon osteotomy provides excellent visualization of fracture and better functional outcome.</p>

scholarly journals Management of Distal Humerus Fractures With Jess Fixator

2015 ◽  
Vol 3 (4) ◽  
pp. 16-20
Author(s):  
Prakriti Raj Kandel ◽  
Kishor Man Shrestha ◽  
Laxmi Pathak
Keyword(s):  
Distal Humerus ◽  
Humerus Fracture ◽  
Medical Sciences ◽  
Distal Humerus Fracture ◽  
Fixation Technique ◽  
Fixation Techniques ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

INTRODUCTION: Fractures of distal humerus are rare comprising approximately 2% of all fractures and a third of all humerus fractures. Even with the development of newer fixation techniques, the treatment of distal humerus fractures remains a great challenge to any orthopaedic surgeon. Thus this present study was conducted to evaluate the results of Joshi's External Stabilization System (JESS) in the management of distal humerus fracture with or without intercondylar extension. MATERIALS AND METHODS: This retrospective study was conducted by collecting records of thirty two adult patients who sustained distal humerus fracture and were managed with JESS fixation under anaesthesia over a period of two years in Universal College of Medical Sciences Teaching Hospital (UCMSTH) after obtaining permission from Institutional ethical committee. RESULTS: According to AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification, 2 patients had C1 fracture and 30 patients had C2 fractures. The mean duration of JESS application was 16 weeks. The mean follow up was 8 months. The functional outcome was evaluated by using Cassebaum's functional rating system. Among C1 fractures, 50% showed fair and 50% showed good result whereas among C2 fractures, 40% showed good, 46.66% showed fair and 13.33% showed poor results.  CONCLUSIONS: JESS fixation technique represents a viable option in the management of open as well as close intercondylar fractures of the distal humerus.

A PROSPECTIVE FOLLOW UP STUDY OF FUNCTIONAL OUTCOME OF SUPRACONDYLAR HUMERUS FRACTURE WITH INTERCONDYLAR EXTENSION TREATED WITH OLECRANON OSTEOTOMY APPROACH

2021 ◽  
pp. 76-79
Author(s):  
Pradeep Choudhary ◽  
Mahesh Bhati ◽  
Ramniwas Bishnoi ◽  
Aditya Srimal ◽  
Jayesh Chouhan
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Range Of Movement ◽  
Mayo Elbow Performance Score ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Frequent Presence

Introduction- Olecranon osteotomy is standard approach for low transcondylar and intercondylar distal humerus fractures. Distal humerus fractures are difcult to manage successfully because of the local anatomic constraints, the frequent presence of comminution,displacement and osteopenia. We studied the functional outcome and complications following surgical xation using this approach. Material And Methods- A total 20 consecutive patients(male:15,female:5),having mean age 42.1yrs, of Distal Humerus fractures who will attend the casualty or O.P.D during the thesis period(June2018 to October2020) at Mahatma Gandhi Hospital & Mathuradas Mathur Hospital Jodhpur (Rajasthan) will be included in study group and managed surgically using olecranon osteotomy approach. Functional outcome was evaluated using the Mayo Elbow Performance Score(MEPS) and complications were observed. Results- Mean loss of extension was 10°.Mean exion achieved was 122.75°.Mean range of movement at treated elbow was 113°. All fractures united by the end of 3 months. Final results were excellent in 8 cases; good in 7 cases; fair in 4 and poor in one case. Most common complication in our study was discomfort due to hardware(6 cases). Supercial infection occurred in 2 cases. Screw/wire backout occurred in 2 cases. Elbow stiffness and malunion happened in one case. Functional outcome was also dependant on fracture subtype. Conclusion- Intraarticular distal humerus fracture treated with olecranon osteotomy approach had good articular exposure and surgical xation. This approach had good functional outcome and fewer complications.

scholarly journals Transolecranon Distal Humerus Fractures: A Mini Review

2021 ◽  
Vol 2 (1) ◽  
pp. 7-12
Author(s):  
Shaan S. Patel ◽  
Julian Gatta ◽  
Adrienne Lee ◽  
Blaine T. Bafus
Keyword(s):  
Pediatric Patients ◽  
Data Extraction ◽  
Adult Population ◽  
Full Range ◽  
Distal Humerus ◽  
Dash Score ◽  
Elbow Stiffness ◽  
Fractures In Children ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Background: Transolecranon distal humerus fractures are uncommon injuries. The purpose of this study is to review the outcomes and complications associated with transolecranon distal humerus fractures. Material and Methods: We performed a systematic search of PubMed for articles published between 1990 and 2021. Included studies reported outcomes and complications of transolecranon distal humerus fractures. Data was extracted from the included studies to describe patient demographics, injury characteristics, outcome measurements, and complications. Results: A total of 4 studies met inclusion criteria for data extraction and analysis. Two studies evaluated an adult cohort of a total of 18 patients. The average Disabilities of the Arm, Shoulder, and Hand (DASH) score was 40 (range 4.2 – 76.5). Fifteen patients (83%) had a complication. Elbow stiffness (11/18, 61%) was the most common complication. Eleven patients (61%) underwent more than one procedure. Two studies evaluated a pediatric cohort of a total of 9 patients. Five patients (56%) underwent non-operative treatment with immobilization and four patients (44%) underwent open reduction and internal fixation. There were no complications reported. All the pediatric patients regained near full range of motion of the elbow at their final follow-up. Conclusion: Transolecranon distal humerus fractures are complex elbow injuries. In the adult population, they remain a challenge for orthopaedic surgeons. Complications, including elbow stiffness and infection, are high with frequent long-term functional limitations as represented by DASH scores. In contrast, pediatric patients have good outcomes and minimal complications that are similar to isolated olecranon and distal humerus fractures in children.

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