Functional Outcome of Intercondylar Distal Humerus Fractures Surgically Treated with Open Reduction and Internal Fixation with a Principle Based on Orthogonal Plating Technique

2021 ◽  
Vol 6 (1) ◽  
pp. 1336-1340
Author(s):  
Santosh Thapa ◽  
Ranjib Kumar Jha ◽  
Ashish Rajthala
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Distal Humerus ◽  
Plating Technique ◽  
Significant Difference ◽  
Dual Plating ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
One Year

Introduction: Owing to the complex articular structure, paucity of metaphyseal bone and thin soft tissue covering, treatment of intra-articular distal humerus fractures still pose challenge to surgeons. Although it comprises 2% of all fractures the massive complication rate to the treatment is worrisome. This study aims to evaluate the outcome of surgical treatment of these fractures by open reduction and internal fixation by dual orthogonal plates. Objectives: The objective of the study is to evaluate the functional outcome of intercondylar humerus fractures managed with open reduction and internal fixation with orthogonal dual plating technique. Methodology: Eighteen patients (19 – 68 years old) with AO/OTA type 13C fractures were evaluated after surgery for one year with MEPS and range of motion. Complications were categorized as major or minor complications. Functional comparisons were made between simple articular type C1/C2 and complex articular type C3 fractures at one year. Result: There were 2 (11.11%) type C1 fracture and 8 (44.44%) each in type C2 and C3 fractures. Eight (44.44%) patients obtained excellent, 7 (38.89%) obtained good and 3 (16.7%) obtained fair results. There was no poor outcome. Average MEPS score was 83.33 and there was no significant between the subgroups (p = 0.07). The average flexion was 118.06° and it was significantly impaired in type C3 fractures (p = 0.03). Three patients obtained full extension, and remaining patients had mean extension deficit of 12°. Average arch of motion was 108.06° with significant difference between two subgroups (p = 0.008). The mean arc of motion for supination-pronation was 154.44°. There was 5 minor and 2 major complications (total - 38.9%). Conclusion: The surgical management with open reduction and internal fixation by dual plates in orthogonal configuration for the intercondylar distal humeral AO type C fractures has good or excellent functional outcome in majority of the patients.

scholarly journals Functional outcome of elbow joint in AO type 13C fractures treated with open reduction and internal fixation using dual plates

2019 ◽  
Vol 5 (3) ◽  
pp. 509
Author(s):  
Uyyalawada Sreedhar Reddy ◽  
Bheemsingh Samorekar ◽  
Vinay J. Mathew ◽  
Anil Kumar Mettu
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Distal Humerus ◽  
Range Of Movement ◽  
Excellent Outcome ◽  
Significant Difference ◽  
Dual Plating ◽  
Type C ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Distal end of the humerus, with its unique orientation of articular surfaces supported by a meagre amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons. Aim of the study is to evaluate the functional outcome of surgical management of intercondylar AO type C fractures of distal end of humerus using dual plating.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted at our hospital between January 2015 to December 2016. Thirty five consecutive patients with intercondylar (AO Type C) fracture of distal humerus, included in study as per inclusion criteria. All patients were treated surgically using triceps reflecting approach and posterior trans-olecranon approach with ulnar nerve exploration and fixation using dual plating and tension band wiring for olecranon osteotomy wherever done.<strong></strong></p><p class="abstract"><strong>Results:</strong> In 35 patients, final results using MEPS scoring system excellent outcome is noticed in 15 patients (42.86%), good results is noticed in 13 patients (37.14%), fair result is noticed in 5 patients (14.29%) and poor result is noticed in 2 patients (5.71%). There was statistical significant difference in flexion range of movement arc at 2 and 6 months in our study.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation of AO type 13C fractures is challenge to surgeon, preoperative planning and mastering the technique over a period of time gives good to excellent functional outcomes.</p><p class="abstract"> </p>

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

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 Functional outcome after open reduction and internal fixation for traumatic diastasis of the pubic symphysis a one year follow-up study

2016 ◽  
Vol 2 (4) ◽  
pp. 256
Author(s):  
B. L. S. Kumar Babu ◽  
Biju Ravindran
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
High Energy ◽  
Walking Distance ◽  
Early Weight Bearing ◽  
Dual Plating ◽  
Pubic Diastasis ◽  
One Year

<p class="abstract"><strong>Background:</strong> Pubic diastasis often results in anteroposterior compression (APC) injuries based on Young and Burgess classification. It is caused due to high-energy trauma and of much clinical importance is given when coexists with urogenital and neurological complications with hemodynamic instability. Open reduction and internal fixation with plating facilitates early mobilisation with better results and is the preferable mode of stabilisation. We evaluated the clinical and functional outcome of such patients in a one-year follow-up period.</p><p class="abstract"><strong>Methods:</strong> In our study, we included 20 patients with APC II injuries who underwent an open reduction by single or dual plating technique by the Pfannenstiel approach, were followed for one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 20 patients, 14 patients (70%) were operated with single superior plating, six patients (30%) were performed with dual plating, i.e., both superior and anterior plating. Among 20 patients, two patients (10%) were operated for primary arthrodesis with double plating. Only one among 20 (5%) had implant failure due to early weight bearing and were re-operated with primary arthrodesis with plating. Results were analysed based on a scoring system which includes five criteria such as anterior pelvic pain, dyspareunia and sexual dysfunction, ability to sit, gait abnormalities and walking distance. Among 20 patients ten patients (50%) had excellent results, six patients (30%) had good results, two patients (10%) had fair results, two patients (10%) had poor results.</p><p><strong>Conclusions:</strong> Open reduction and internal fixation of traumatic pubic diastasis in type II APC injuries with single or dual plating had given better results and early functional recovery.</p>

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